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Customer Service Medical Billing

Location:
Flint, Michigan, United States
Salary:
$69,000 or more
Posted:
February 07, 2019

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Resume:

Chari L. Jones

P.O. Box **** Flint, MI *****

810-***-**** (mobile) ac8e7r@r.postjobfree.com

QUALIFICATIONS

A driven IT professional with an educational background in planning, analyzing and implementing solutions in support of required objectives. Ability to provide comprehensive secure network design, systems analysis and full life cycle project management. Hands on experience leading all stages of system development efforts, including requirements definition design, architecture, testing and support. Outstanding project and program leader; able to coordinate and direct all phases of project-based efforts while managing, motivating and guiding teams to a successful delivery.

CERTIFICATIONS IN PROGRESS & COMPLETED TECHNICAL PROFICIENCIES

CISSP CERTIFIED Information System ISSA Information System Security Association

MOSC Microsoft Office Specialist Certification A + Certification, 2011

Platforms: UNIX Windows 9x/NT/2000/XP/Vista Linux Mac OS VM/370

Networking: TCP/IP Novell DECNET SO/OSI IPX/SPX SMS/SQL

EHTERNET Secure ID PGP PKI HIPPA

MICROSOFT EXCEL SQL - DEVELOPER ACCESS

Languages: UNIX Shell Scripting C Web Page (HTML) Java Script Java

VBA

Tools/Applications: Lotus Notes Excel & Microsoft Office Suite Data Entry Visual Basic Fox Pro

COBOL dBase IV Microsoft Money Olympic System Drivers Analytical

CEO (Computer) Flowcharts Quality Control Professional File Problem solving

MOST RELEVANT EXPERIENCE

ENTECH AGENCY HEALTHPLUS OF MICHIGAN, Flint MI Nov 2013 – Dec 2014

IT PROVIDER NETWORK ANALYST

Initiating, documenting, tracking and screening provider application request by:

Developing and maintaining accurate provider application materials and contract templates

Coordinate credentialing process with Quality Management Credentialing Department

Send out necessary documents for provider applications i.e. W-9, Intake, Contracts Forms, etc.

Monitor database on an ongoing basis to maintain integrity of data and identify and resolve data issues contained therein.

Responsible for organization and corporate reporting provider network data utilized in and reported through the Corporate Score Card and the Presidents Report.

Communicate with provider, internal and external customers, such as PHO Administrators to facilitate and track status of provider application requests, provider record change request to ensure HealthPlus provider database is accurately maintained for external publication.

Provide on-going status reports of e provider credentialing process to Provider Network Management, Legal and Physician Hospital Organizations and others, as applicable.

Maintain on-going communication with IS, Provider Network Management and Customer Service Departments to ensure provider data is consistently updated, accurately reflected in multiple systems and current on he corporate website, at all times.

Produce customized provider directories for all product lines for external and website use by: employer groups, County Health Plans, Sales and Services, PHO and PO’s.

Direct involvement in the analysis and recruitment of providers.

Other duties as assigned

Work on special projects for different departments.

Completing the 020 Process Steps by closing out and implementing notes for PIM, LEGAL and Credentialing Department.

Mailing out contracts to providers and ensuring the addresses are correct.

Upgrading spreadsheets for P.N.M. Department

ADDITIONAL PROFESSIONAL EXPERIENCE

ALTEGRA HEALTH / CHANGE HEALTH, Flint MI December 2016 – Present

FIELD REVIEWER ADVOCATE

Document management including scanning and saving patients documents

Reviewing information that has been scanned

Attaching documents to EMR & LIDS

Uploading & managing charts

Medical Billing

Coding / ICD9

UAW LOCAL 659, Flint MI April 2015 – On Call

ADMINISTRATIVE RECEPTIONIST

Proving detailed information to Union Reps

Documenting and keeping track of all Legal Binding information

Modifying event flyers

Scheduling meetings for the President of UAW and sometimes leading them

Issuing 409’s for vacation time for General Motors employees

PITNEY BOWES, Flint MI May 1996 – Feb 2009

Follow Up Team Leader

Processed Warranty claims from other vendors by handling incoming and outgoing documents that consisted of personal data for General Motors.

Handled accountable express packages: Fed-Ex, U.P.S. and DHL.

Placed orders throughout the GM Facility for customers/employees using Boise.

Directed workflow by providing service to customers that consisted of sorting, processing and distributing mail.

Proofread corporate material, made necessary modifications and communicated changes throughout organization.

Examined work queues for requests in jeopardy of missing service agreements.

EDUCATION

Associate of Applied Science, Computer Information Systems 2011

University of Davenport, Grand Rapids, Michigan

DURANT TUURI MOTT ELEMENTARY (Flint, MI) September 2011 – June 2013

Served as assistant coach to boys Basketball team.

Mentored students academically.

Helped organize school events (including fundraisers, school dances, talent show and science fair).Donated money, food, clothes and created holiday baskets to assist homeless families.

RECOGNITION

Letters of outstanding service from parents, teachers and students

Received High Reviews

Awarded Certificate of Achievement in Customer Service Star

Employee of the Month



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