Customer Service Medical

SHERONDA STEELE

**** *. ********

Chicago, IL ***39

(312)-476-0621or 773-***-****

*********@*****.***

PROFILE

Results-oriented professional with a background in Data Entry and Medical

Billing & Coding as well as a proven track record of success in Insurance,

Customer Service, Accounting, and Administrative Support.

SUMMARY OF QUALIFICATIONS

. Medical Terminology

. Anatomy & Physiology

. HIPAA Regulations

. Facility Billing

. Reimbursement Systems

. Government & Third-Party Payers

. Electronic Medical Records (EMR)

. Managed Care (HMO, PPO & POS)

. Insurance Claim Billing & Processing

. Diagnosis Coding from Medical Records

. Medical Office Procedures

. Keyboarding & Word Processing

. Medical Practice Management Systems

. TRICARE, Medicare & Medicaid

. MOSS & MEDISOFT

. Medecision

. AS400

. CPT- 4

. HCPCS

. ICD-9-CM

EDUCATION

Ultimate Medical Academy - Tampa, FL 2010-

2011

Medical Billing & Coding Diploma

. Working towards CPC Certification

Truman College - Chicago, IL 1993-

1994

General Studies

PROFESSIONAL EXPERIENCE

Sunshine Home Care - Elmwood Park, IL

2012- Present

Medical Biller and Coder

. Worked closely with other billers to ensure that charges are billed

correctly and that monies

are being brought in the facility

. Billing using the UBO4 forms

. Verify and enter patient demographics and insurance information into

the billing system and patients calls on billing

questions

. Communicate with insurance companies to receive eligibility, benefits

and prior authorization for home health services to be rendered

. Assign codes to procedures and diagnoses which are used to determine

the amount of insurance payments

. Verify that CPT, HCPCS and ICD-9 codes submitted to the insurance

companies are accurate representation of the medical services rendered

by the providers and facility

Kelly Services - Chicago, IL 2007-

2009

Financial Assistant - Blue Cross/Blue Shield

2008-2009

. Maintained current and accurate disbursement check application

information

. Answered calls from physicians and members checking the status of

checks

. Prepared daily reports, processed payments, oversaw filing, and

updated member data

Customer Advocate

2007-2008

. Responded to customer inquiries, researched data, and processed client

information

. Utilized Medecision software to initiate cases for preauthorization

using CPT and ICD 9 codes

. Adhered to HIPPA standards, oversaw clinical reviews, and coordinated

enrollment efforts

Automated Health Systems - Schaumburg, IL

2006-2007

Customer Service Representative

. Maintained primary case management programs and handled inbound calls

. Communicated with clients in a medically sensitive manner and

explained Medicaid services

Arrow Financial Services - Niles, IL

2003-2005

Account Representative

. Negotiated settlement for accounts by providing creative alternative

payment plans

. Worked with a wide range of clientele and kept accurate records for

collections

Parker Hannifin - Broadview, IL 2000-

2003

Accounting Clerk

. Prepared periodic reports, audited accounts payable, and maintained

databases

. Contacted customers regarding delinquent accounts and indexed purchase

orders

RELEVANT SKILLS

. Strong background in customer service, financial operations, and

administrative support

. Able to multi-task and work effectively with a large volume of

information

. Highly organized and capable of prioritizing workloads to meet

deadlines

. Front office skills with the ability to identify and address customer

needs

. Motivated, attentive, and willing to learn

. Amiable and productive in team environments

. Possess a thorough knowledge of modern clinical practices and

procedures

. Computer savvy and familiar with many systems and applications

including AS400, MS Office Suite, MOSS, Medecision, and MEDISOFT

Proprietary Software

Contact this candidate