Customer Service Medical Billing
Resume:
Sureece Jeffers
Indianapolis, In *6239
***********@*****.***
Objective: Seeking a position as a dedicated member of you team where I can utilize my skills to meet
and exceed monthly goals.
Summary: In my profession I am a proven performer with many years of experience in training, claims,
customer service, auditing, file corrections, coordination of benefits, recovery and reconsideration,
subject matter expert, leadership, project management, commercial/Medicare billing, and provider billing.
My experience has helped me to build leadership, communication and relationships with people at all
levels. My willingness and ability to change, improve and learn are remarkable. I like to motivate others,
lead by example and will help in any area possible. I learn facts quickly and adequately, prioritize and
delegate task. I reach beyond my current skill level and produce at levels expected from those above me.
Key Skills: Multifunctional
Training – Classroom, Web based, E-Learning, Teleconference etc...
Subject Matter Expert
Leadership
Claims
Customer Service
Auditor
Recovery and Reconsideration
Coordination of Benefits
Medicare/Medicaid Benefits
Commercial/Medicare/Medical Billing
Provider Billing/Patient Billing
HCPC, ICD9, ICD10
Medical Terminology
Systems:
• Microsoft Word advanced – 12+yrs experience
• Microsoft Excel advanced – 9 +yrs. experience
• Microsoft Outlook advanced – 12+yrs experience
• PowerPoint advanced – 7+yrs experience
• SharePoint advanced - 9+yrs experience
• Adobe advanced – 10 +yrs. experience
• CMS (Medicare) advanced – 11+yrs experience
• Medicaid system advanced - 12 yrs. experience
• Networx pricing advanced – 8+yrs experience
• Trizetto pricing ship advanced - 8+yrs experience
• Claim Assist advanced – 6+yrs experience
• Facets intermediate 5+yrs experience
• On Demand advanced – 6+yrs experience
• GP00 advanced – 5+yrs experience
• Oracle advanced – 10+yrs experience
• Amysis Intermediate – 5 yrs. experience
• Availity Intermediate – 6 mos. experience
Work Experience
Rural/Metro, Inc.
2/12 – 5/12
Indiana Medicare Customer Service Rep
Billing Specialist:
This position consisted of billing Medicare claims for our provider R/M ambulance. My job consisted of
billing out ambulance claims to Medicare, Medicaid, Commercial Insurance and/or patients. Investigating
and updating patients’ files with current accurate information via calling facility, calling patients, utilizing
varies online applications including Availity, and/or next of kin. Requesting face sheets, medical
necessity, explanation of benefits, and appeals. I would review run reports/patient care reports (pcr), and
physicians’ certification statement (pcs).
WellPoint, Inc
3/08 – 8/11
Trainer: Promotion
Conducted new hire claims, customer service, professional, facility, dental, multifunctional, coordination
of benefits, adjustments, recovery, e-learning, benefits, Magic and lunch and learn classes. Developed and
maintained training program, standard operating procedures (SOP’s), manuals, power points and
materials. Analyzed, designed, develop and evaluated training programs with the appropriate delivery.
Worked as a subject matter expert for all lines of business and assisting on projects for Business Analysts
and Management.
WellPoint, Inc
10/05 – 3/08
Recovery, Reconsideration and File Corrections Specialists: Promotion
My position consisted of investigating and making sure files were loaded correctly, claims were processed
correctly and priced accurately. Received or set up refunds from providers and members, processed
adjustments, voids, reissue checks, loading files, eligibility, Medicare match, and train new coordination
of benefits (COB) processors. Developed and enforced guidelines for COB while auditing their files.
WellPoint, Inc
5/07 – 8/07
Operations Expert: Promotion
Effectively monitored the “gaps in production”, router, old claims reports and worked claims 25 days or
older. Redirected resources for processing as necessary within my team, provided feedback to associates
on their performance, communicated work flow changes to my team. As well as communicate and
worked with pre-auditors on error disputes on a daily basis.
WellPoint, Inc
1/02 – 10/04
Coordination of Benefits (COB) Specialists: Promotion
My position consisted of coordinating and processing professional, dental and facility claims for all
states. On a daily basis I enforced the federal regulations for coordinating with other insurances and third
party administrator. To ensure accurate information I contacted providers, members and other insurance
companies verifying information. Acting SME for COB while maintaining my and job and work
performance. Also assisted with difficult situations being that “go to person” for leads, auditors, cob,
processors, trainers and management.
WellPoint, Inc
12/01 – 01/02
Claims Processor:
This position consisted of processing professional, facility, dental, Medicare and Medicaid claims being
accurate with quality and quantity.
Certificates
Claims Processing
Train the Trainer (TTT)
Facilitating for Excellence
Managing Multiple Projects, Objectives and Deadlines
M.A.G.I.C. – Making A Great Impression on our Customers
Educations
Arsenal Technical High School 1994 Graduated
Ivy Tech College 1995 – 1997 Did not obtain degree
Penn Foster College 2010 – 2011 Degree seeking in Health Information
References upon request
Contact this candidate