Marjorie Lynn Bardill
La Vergne TN 37086
OBJECTIVE:
Seeking a position that will challenge my abilities and allow me to further my career opportunities. I am willing to learn new techniques to enhance my job skills.
EDUCATION:
Hume-Fogg Vocational Technical High School Non Profit Management – Certified
Nashville Tech, Middle Tennessee State University
Department of the Year 2010 - Prime Health Services
Employee of the Year 2015 – Prime Health Services
EXPERIENCE
Prime Health Services
Bill Review Lead
Present - 2016
Process Worker’s Compensation claims for a variety of clients, including implantation of State Fee Schedule (SFS) and/or U & C reductions. Ensure correctness and quality of claims process. Assist in resolution of Medical Bill Review disputes. Works closely with Data Implementation Specialist on SFS to ensure claims are processed at correct SFS and/or U & C reductions. Alerts Data Implementation Specialists when system does not apply correct SFS rates. Finalize all claims and address any issues with Data Implementation Specialist when system does not apply correct SFS. Proactively manages client’s expectations to achieve appropriate claim outcomes. Communicates with Manager and Accounting Staff on claims processed and assist on any issues.
2007-2016 Prime Health Services Inc. Christina Hancock,
7112 Crossroads Blvd Suite 101 Brentwood, TN 37027
Re-pricing/Reconsideration Specialist Lead
Duties include re-pricing medical claims - Worker Comp, Group Health and Auto claims for assigned accounts, Reconsiderations for Worker Comp, Group Health and Auto. Work closely with clients on claims issues concerning ppo discounts for PHS as well as affiliated networks. Responsible for processing Corrections Claims for the different Sheriff Department in various states. Send out correspondence to provider, document any issues with providers concerning PPO discounts or contract. Assist the Account Manager as needed, maintain and send out Weekly Reports. Maintain various spreadsheets on claims processed and sent to various Counties for payment. Coordinate with Director of Dept. to assist Co-Workers in logging and working PPO disputes as needed, as well as working on special projects.
10/06 – 03/07 Medical Management Services of Nashville Debbie Dye – Supervisor
345 24th Avenue North Suite 209
Nashville, TN 37203
Medical Billing Specialists
Duties included posting charges for Blue Cross, Medicaid, Medicare, EOB’s, logging in checks for clients, also did electronic posting. Filled in on front desk as needed.
10/98 – 10/06 MMS Claims Re-Pricing Management Jack Moore – Manager
345 24th Avenue North Suite 208
Nashville, TN 37203
Office Manager
Duties included sorting, verifying and re-pricing medical claims for Tennessee Healthcare. Ran daily operations for manager, supervised staff and kept within the three day turn around on claims. Handled problem calls from providers, patients, and TPA’s. Work closely with TNHC on special projects as requested. Trained new employees on system.
11/97 – 10/98 St. Luke’s Community House Douglas Anderson - Director
5601 New York Avenue
Nashville, TN 37209
Administrative Assistant
Duties included providing administrative and secretarial support to the Executive Director, and staff as needed. Produced and maintained donor database. Prepared agency correspondence and necessary follow-up. Handled all correspondences, files, documentations and phone contact as direct by Board and Committee members. Assisted in preparation of quarterly newsletter, including desktop publishing and assembly for mailing. Prepared presentation materials. Assisted in media relationships to include press releases.
REFERENCES:
Available upon request.