Customer Service Medical

**** ******* **. **** 909-***-****

San Bernardino, CA 92404 E-mail **************@***.***

Shenay N. Holloway

To obtain a position within a Health Care Facility, where I can utilize my

Objective

leadership skills, knowledge and professionalism.

I have the ability to organize responsibilities for maximum output, increase

Summary of cash flow. Possess and eye for detail and strong work ethics. I execute

projects using limited resources. Problem solving, leadership and

qualifications

communication skills are some of the qualities developed from my

experience related to the healthcare industry and customer service.

09/2008 – Present University of Phoenix San Bernardino, CA

Education

Business Administration

B/S in progress

03/2004 – 01/2005 Four D Success Academy Colton, CA

Health claims examining / Medical billing & Coding

Certification

05/2003 – 01/2004 Summit Career College Colton, CA

Medical office operations

Certification

11/2011 – Present AccentCare Inc. Ontario, CA

Professional

LTC Reimbursement Specialist Lead

experience

Manage all aspects of day-to-day claim submission, Eligibility verification,

Billing for services rendered, Finances: accounts payable/receivable, invoicing,

insurance billing, Account and Claim auditing, Compliance with all healthcare

facility, HMO, and insurance requirements.

03/2010 – 02/2011 Hallmark Surgical Center San Bernardino, CA

Medical Coder/Biller

On-site coding support, remote coding services, coding, auditing and reviewing

operative reports and medical charts for accuracy, assigns and sequences ICD -

9CM/CPT/HCPCS codes to diagnoses and procedures for documented

information, assures the final diagnoses and operative procedures as stated by

the physician are valid and complete, abstracts all necessary information from

health records to identify secondary complications and co -morbid conditions to

submit claims to the insurance company, and educate and train medical staff.

02/2009 – 08/2010 American Career College Ontario, CA

Health Claims Examiner/Medical Billing & Coding Instructor

Delivers class instructions according to an approved course syllabus using

accepted and effective teaching methods; develops daily lesson plans; advises

and tutors students; maintains current and accurate attendance and grade

records; remains current in applicable program teaching field; participates in

faculty meetings, student functions, graduation exercises, open houses, new

student orientations, and advisory board meetings.

08/2004 – 05/2009 Beaver Medical Group Redlands, CA

Patient Account Specialist III

Organize In – Patient and Out – Patient claims for electronic or hard copy

mail and forwards to appropriate primary, secondary, or third party payer.

Reviews claims to make sure that payer specific billing requirements are

met, follows – up on billing, determines and applies appropriate adjustments,

answers inquires, and update accounts as necessary. Schedule insurance re -

bills in a timely manner, receives and resolves incoming calls from patients

and insurance companies on accounts. Obtains additional information needed

to submit appeals on denied claims and inappropriate underpayments.

Receives updated pricing information when terms of billing contracts

change. Ensures files are properly documented with insurance information

and other information required for billing and collections. Ensures that

appropriate charges are entered in a timely manner. Review and ensure

coordination of benefits have been verified and entered into the A/R system

appropriately. Maintains a good working knowledge of Governmental,

Senior and Commercial carriers. Process returned / rejected mail by

contacting patients/hospitals and utilizing outside sources. Completes final

reviews on accounts to assure all efforts have been exhausted to collect

payment before submitting to our collectors and various other offi ce duties

including special projects and working reports.

07/2000 – 07/2004 Gateway Medical Group Irvine, CA

Member Services Supervisor

Supported daily operations of department by assisting and providing

direction to employees as required, Coordinated multiple tasks supporting

the department. Ensured projects were completed on schedule following

established procedures and schedules. Interviewed, trained, evaluated and

disciplined production staff. Provided direction, guidance, coaching,

professional development and training. Maintained professional work

environment among employees and resolved grievances, Maintained up to

date knowledge of current and future applications that relate to the

operations and the business requirements of the department. Act ed as a

liaison between Management, other departments and supervised staff.

Facilitated communication between related departments and own

department. Resolved errors and complaints from client departments and

other Managers. Assisted Managers/Supervisors in researching, compiling

and creating reports from databases and spreadsheets for management

reports. Performed ongoing operational tasks for department as needed.

Contact this candidate