Insurance Microsoft Office
Resume:
Ankeny, IA *****
**********@*****.***
SARAH AHMED
OBJECTIVE
To create a team environment where efficiency, excellence and the sharing of ideas is engrained within the culture. SKILLS & ABILITIES
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Exceptional at maintaining strong relationships with internal and external vendors.
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Vast experience as a single point of accountability for reviewing and reconciling invoices as well as database management.
• Excellent oral and written communication skills.
• Proficient in Microsoft Office, Outlook, Medisoft, BillFlash, Practice Fusion & Navigator.
• Strong organization and time management skills
• Creative niche for process development, optimization and innovation.
EXPERIENCE AMERIGROUP IOWA, INC-WEST DES MOINES, IA March 2017-Present
• Gathers clinical information regarding case and determines appropriate area to refer or assign case (utilization management, case management, QI, Med Review).
• Provides information regarding network providers or general program information when requested.
• Act as liaison between Medical Management and/or Operations and internal departments.
• Maintains and updates tracking databases.
• Prepares reports and documents all actions.
TRUE LIFE WELLNESS-WAUKEE, IA May
2016-December 2016
• Track insurance payments
• Scrubbing of claims
• Handle all related to submitting insurance claims
• Verify insurance eligibility and benefits for new patients AETNA-URBANDALE, IA
April 2015-May 2016
• Receive notification of patient admission to hospitals in the state of Iowa.
• Build cases for authorization and assign cases to Utilization Review Nurses.
• Obtain clinical and make sure appropriate nurses receive them.
• Build denial letters of different levels of care. Once they are reviewed, mail them out to the facility, provider, and/or patient.
• Notify certain facilities of pending authorizations and request clinical.
• Help track high dollar admission
UNITYPOINT-METHODIST HOSPITAL-DES MOINES, IA
July 2014-July 2015
• Verify insurance, obtain HMO preauthorization, obtain insurance precertification, and prescreen diagnoses and procedures for medical necessity 3rd as needed.
• Correct & identify registration errors.
• Apply for Presumptive Medicaid & submit 3Day Emergency Applications to DHS.
• Follow up on Presumptive Medicaid & 3Day Emergency Applications.
• Assist patients in applying for appropriate insurance through the Marketplace.
EDUCATION MEDICAL CODING AND INSURANCE CERTIFICATE-DMACC Scheduled completion date: Summer 2018
BACHELORS DEGREE IN HEALTHCARE MANAGEMENT-SNHU
Anticipated completion date: May 2020
CERTIFIED BILLING AND CODING SPECIALIST -NATIONAL HEALTHCARE ASSOCIATION Completion date: May 17, 2018
COMMUNITY Animal Rescue League of Iowa, ARL-Main, 2015-Present SERVICE Boys and Girls Club, Springfield, MO, 2009 Vice President of L1N, Evangel University, 2008-2009 Lifesong Church, Reeds Springs, MO, 2008-2009
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LEADERSHIP & Created the Quality Reference Guide playbook for all essential team tasks and INNOVATION duties.
Head of the Fax Team in the LTSS Department of Amerigroup, INC. Trainer and Mentor for new hires.
REFERENCES
RYAN THORSBAKKEN-AMERIGROUP INC
CHRISTINA BOAT-AMERIGROUP INC
TAMMY FORREST-UNITYPOINT IMMC
BRETT GROTH-AETNA
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