Customer Service Manager
Resume:
Mandisa A. Davis
Huntsville, AL 35802
abiptj@r.postjobfree.com
Summary
Administrative support professional experienced in working in fast paced environments
demanding strong organizational skills. Critical thinking and listening skills along with decision making
and problem solving skills. Ability to compose comprehensive statements using proper grammar and
sentence structure. Extensive knowledge of Medicare and Medicaid regulations. Professional phone
etiquette with proper use of grammar. Committed to superior customer service. Confident and poised
interactions with individuals at all levels. Detailed-oriented and resourceful in completing projects; able
to multitask effectively.
Experience Highlights
10/2009 – Present Appeals Resolution Specialist / Diatherix Laboratories
Conduct audits involving the entire revenue cycle, including charge capture,
billing and reimbursement
Assist in the recovery of lost revenue through review of documentation and
reporting
Gather supporting information, documentation or clarification of any audit
discrepancies
Negotiate with third party auditors to communicate specific issues and trends
Utilize EOBs and remittance advices to verify denial and identify avenues of
appeal
Contact third party payors, insurance medical directors, case management and
utilization review to request reconsideration for payment
Provide documentation and comprehensive data to justify appeals
Serve as a resource for others when issues/needs are of billing nature
Maintain policy and guidelines of medical audit and charge capture as well as
education materials
Ensure that all assigned grievance issues are resolved within appropriate time
restraints
Handle inbound calls related to appeals and related issues
Complete and thoroughly document all issues
Examine and identify ways to improve existing processes/workflows
Escalate issues appropriately or work with other departments to resolve claim
issues
Perform any other job related task as requested, with reasonable accommodation
Ensure all HIPPA and State requirements/regulations are adhered to at all times
5/2008-10/2009 Medical Coder / Medical Data Solutions
Analyze and code surgical procedures and diagnosis using ICD-9 & CPT-4 codes
Utilize advanced, specialized knowledge of medical codes and coding procedures
to assign and sequence appropriate diagnostic/procedure billing codes in
compliance with third party payer requirements
Interact with physicians and other patient care providers regarding billing and
documentation policies, procedures and regulations
Monitor billing performance to ensure optimal reimbursement while adhering to
regulations prohibiting unbundling and other questionable practices
Interact with department managers and other administrative staff regarding
implementation of new codes and revision of charge documents
01/2006 – 01/2009 Medical Insurance Specialist / Medical Data Solutions
Process billings to patients and third party reimbursement claims
Process patient statements, post transactions and verify accuracy of input to
reports generated
Research and respond via telephone and written communication to patient
inquiries regarding billing issues
Prepare and submit clean claims to various insurance companies via electronic
submission or paper claim
Follow up on submitted claims, monitor unpaid claims, and resubmit claims as
necessary
Maintain patient demographic information and data collections systems
Maintain strictest confidentiality; adhere to all HIPPA guidelines/regulations
06/2003 – 01/2006 Accounts Manager / ADS Security
Scheduled appointments and maintained accurate customer files
Provided telephone support to customers
Assisted potential and existing customers identify services and products
Demonstrated an ability to maintain composure and work efficiently in fast paced
setting
Typed and distributed all correspondence
Provided reception service
Planned and successfully executed consolidation of two companies
08/1999 – 05/2003 Department Manager / Gap Inc.
Provided excellent customer service
Trained associates in all applicable policies, procedures and programs
Audited cash controls
Upheld company standards for merchandising presentation
Participated in interviewing and hiring for hourly associates
Ensured compliance to all guidelines involved with safety, loss prevention and
cash handling procedures
Education
Alabama A&M University, Normal, Alabama
Business Management (1994-1999)
Hazel Green High School, Hazel Green, Alabama
Advanced Diploma (1994)
References
Barbara Kauffman
Diatherix Laboratories
Billing Director
601 Genome Way
Suite 4208
Huntsville, AL 35806
Lasonya Nix-Haygood
Medical Data Solutions
Human Resource Manager
2009 Gallatin Street
Huntsville, AL 35801
Mellissa Robinson
ADS Security
Office Manager
500 Wynn Drive, Ste. 501
Huntsville, AL 35816
Tina Dejarnett
Gap, Inc
Store Manager
Birmingham, AL
Contact this candidate