Medical Services
Resume:
Tolanda Moye
*******@*****.***
Work Experience
Trailblazer Health Enterprises, L LC
Data Prep Tech I
November 2009 to Oct. 2013
• Download PS&R's, maintaining files, archiving, scan representation letters,
• Keep t rack of the HOT files.
• Create files for the auditors
• Identifies, prepares, and distributes correspondence regarding overpayments and
refunds.
• Performs scanning and/or assists with indexing/imaging financial documentation
to maintain electronic historical records.
Claims Analyst
March 2009 to November 2009
• Enter Medicare Part B manual entry paper claims
• Optical Character Recognition (OCR)
• Electronic Media Claims (EMC)
• Determine whether to pay, deny or return claims as unprocessable based upon
established processing procedures and guildlines.
• Process claims in accordance with Centers for Medicare and Medicaid Services
(CMS) and internal requirements.
• Independently resolve system edits, audits and claims errors through research and
use of approved reference and investigative sources
• MedTex, Mutli-Carrier System, Automated Development System
• Develop and maintain a working knowledge of Medicare rules/regulations, medical
terminology, anatomy, diagnosis and procedure coding th ru department t raining and
education
• Process claims in t imeliness as defines by CMS through the monitoring of
i ndividual aging and tem workload volume.
Enrollment Analyst
October 2008 to March 2009
• Enrolling Providers into Medicare.
OCR Clerk I
December 2007 to October 2008
• Verify OCR scanned claims in assigned region and form family in Anydoc
• Submit OCR verify help sheet for problems/situations that the Anydoc Verify
M anual does not address.
Corestaff Temp
October 2007 to December 2007
• Entered medical information into computer such as arr ival and departure t ime,
doctor's names, nursing name, and patient's names.
OCR Clerk (Kelly’s Services)
August 2007 to December 2007
• Verify OCR scanned claims in assigned region and form family in Anydoc
• Submit OCR verify help sheet for problems/situations that the Anydoc Verify
M anual does not address.
Harley Davidson Financial Services (Kelly’s Services)
Data Ent ry Clerk
March 2007 to July 2007
• Completed Credit Application
• Called Dealers to verify information on application
FedEx K inko's (Volt Temp Agency)
Data Ent ry Clerk
January 2007 to February 2007
• Entered customer information on existing spreadsheet
Criminal District Court of New Orleans
Docket Clerk
August 2001 to August 2005
• Entered court's information into terminal
• Typed subpoena and issued them
• Completed next days docket for court
• Customer Services
• Filed and faxed
Skills
Data Ent ry Keystrokes 12,000, 10-key by touch 15,000 and typing 60 wpm
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