Data Entry Medical
Resume:
Karen Swain
Raleigh, NC *****
*********@*****.***
PROFESSIONAL SUMMARY
Administrative and technical customer support professional with excellent communication skills; comfortable working in fast-paced environments demanding strong organizational and interpersonal skills. Seeking a position conducive to growth and further development of my business skills.
PROFESSIONAL EXPERIENCE
Health Management Systems (Raleigh, NC) 02/2006 – 08/2017
Subrogation Case Worker I
Evaluated Medicaid Recoveries
Effectively work, maintain and manage a variety of cases with current and accurate notes from
creation to recovery
Interpreted diagnosis codes, EOB codes, Provider Specialty Codes
Verified income, county codes, all Recipient information
Cash receipts, Identify provider refunds, Refund Inquiries
Data Entry-Keying new cases into HER systems
Confirm and validate third party liability and probate and beneficiary asset research
Inbound/Outbound phone calls, multi-lines
Negotiate and compromise claim/lien settlement amounts per contract guidelines
Conduct ongoing periodic follow up on case status and payment
Confirm documentation of eligibility for beneficiaries
Interfaced with attorneys, insurance adjusters and medical providers
Stock Builders Supply (Raleigh, NC) 2/2005- 11/2005
United Healthcare (Cary, NC)
Siemens (Wendell, NC)
Data Entry/Billing
• Entered Invoices in a timely manner
• Scanned Invoices in system to be retrieved by data entry levels
• Assisted billers with processing denials/appeals
• Ran reports, quality checked invoices against reports
• Researched discrepancies on invoices involving discounts
Public Consulting Group (Westaff, Inc.)(Raleigh, NC) 08-2004 –02/2005
Accounts Receivable Representative
NC Medicaid System/MMIS – Verifying Eligibility, Cash Receipts, Provider information, viewing paid/denied claims/Recipient information
Supervised over 8 people
Time clock updates/Timesheets for over 20 people
Data entry
Research and follow-up of denials
Posted, worked and keyed denials
Maintained several Excel spreadsheets
Explanation of Benefits
EDUCATION
Caldwell College Wake Technical College
1979 – 1983 Medical Coding I – 05/2004
SKILLS
10-key touch HCPCS
Microsoft Word MMIS
PowerPoint NC Tracks
Access Keyboarding 55 wpm
Excel ICD-10 Coding
Data Entry ICD-9 Coding
REFERENCES AVAILABLE UPON REQUEST
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