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Medical Data Entry

Location:
United States
Salary:
46,000
Posted:
March 24, 2019

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Resume:

GEORGE TAYLOR M CDAVID

Bronx, NY ***** 718-***-****

ac8vxo@r.postjobfree.com

PROFESSIONAL SUMMARY (COLLECTIONS, CONSULTING, ACCOUNTS PAYABLE) BILLING,

AUDITOR)

** ***** ** ******* *** 4 years Army Veteran with background in Human Resources: Human Resources Information Systems,

Background Investigations, Audits, Payroll, Benefits and Training. Experienced in Legal, Healthcare and Insurance industries.

Accomplished measurable results working independently and working in teams in a dynamic, fast-paced environment. Comprehensive

background in business operations, account management and program management derived from working as an Analyst. Mitigated and

managed risk to protect individuals and assets valued over $1M while meeting expectations of senior leadership. Extensive knowledge in

Collections, Accounts Payable/Receivables, Worker’s Compensation, Medical Claims/Payments, Fraud and Client Relations. Open to

new opportunities.

Account Management Fraud/Investigations/Adjudicat Workers'

ion Compensation/Disability

Recovery

Solutions/Collections Forecasting Revenue OSHA Standards

Human Resources/Benefits Settlement FMLA Protocols

Database Operations Negotiation/Contracts Contract Obligations

Audits/Litigation/Medical

Claims

P R O F E S S I O N A L E X P E R I E N C E A ND ACHIEVEMENTS

From the period of April 2017 employment situation has involved collecting severance, unemployment and assignments involving

data entry, administrative work, consulting remotely from home: Asides Consulting Corp and taking care a loved one. I am

available .Registration with Robert Half.

Collections( Subrogation) Resolution Analyst (Electrical Safety Account)

Collaborated with senior partners to discuss the effects of third party settlements and status of accounts receivables.

Analyzed client’ s account. Calculated amounts due and acquired lien amounts for debts; conducted audits and double-checked

filing requirements, processed invoices.

Actively maintained AS400 computer system for data entry, processing payments, and collections data.

Established reserves and budgets with modifications for recovery cases utilizing financial analysis for accuracy.

Introduced new procedures for collecting subrogation recoveries in addition to a system that yielded a forecasted $1.5M in

revenue per annum, now standard for the company.

Implemented the next steps for resolving an issues with Special Funds and the Department of Taxation.

Conducted claim audits to reimburse medicare.

Reviewed contracts and authorized settlements.

Forecasted revenue and prepared reports utilizing Excel computer application.

Consultant/Accounting (Various Insurance Companies' Account)

Generated subpoenas for medical records related to diabetes, orthopedic injuries, and high blood pressure; subsequently

researched pharmacy prescriptions for reimbursement, social security, medicare as advisor to insurance companies obtaining

reimbursements.

Conducted investigations pertaining to fraud and assigned various investigation agencies . Reported cases to the Office of

Inspector General.

Oversight for Accounts Receivable and Accounts Payable in addition to expenses earmarked for resolving payment problems.

Drafted pre-trial and trial write-ups that allowed the client to receive recovery amounts above 50%.

Financial Claims Analyst (Lenox Hill Hospital Account)

Drafted material goods accounting reports in addition to total benefit costs per New York State guidelines.

Managed money transactions of workers compensation claims ; indemnity and medical payments, ledgers and supervised bill

payers.

G EORGE T AYLOR M C D AVID

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Accountable for cases involving FMLA, payroll, and OSHA.

Consistently achieved an 85% to 95% audit ratings from public accounting agencies.

Used cost containment programs and auditing to reduce medical and disability claims costs by 150K.

Resolved transaction-related issues with accounting and banking departments with costs of over $50K per month.

Billing Analyst (Legion Account)

Oversight for workers' compensation medical claims currently in liquidation in addition to related risk transfers.

Consistently achieved a $12K goal in billing for the company by way of audits and cost containment. .

Analyzed medical claims and prepared budgets for medical claim cost. Reviewed and audited medical claims consisting of

ICD9, ICD10, DRG, CPT, PAS codes in accordance with guidelines.

Claims Auditor/Team Leader (Taxi Commissions Account))

Conducted audits on claim cases.

Drafted status reports to supervisors and stakeholders. Collaborated with associates to design strategies for medical and

indemnity cost reduction and for closing on cases.

Limited the company’s liability by transferring death cases to the state fund.

Reinsurance Accounting Analyst

• Cleaned-up a backlog of treaties and books of business from AIG, Aon Re Worldwide, Benfield, Guy Carpenter and Travelers Gulf

Insurance, a claim inventory of 2000 cases: Life, Accident and Dismemberment and Catastrophic Workers’ Compensation cases .

Identified, reviewed and verified contract provisions, Audited TPAs. Developed Accident Valuation Models to forecast reserves levels.

Issued cash disbursements upon receipt of precautionary notices. Teamed with Management and Actuaries to discuss contract

obligations.

WORK HISTORY

Accounts Payable ( Remote Position), Asides Consulting Corp, Cumming, Georgia, 4/17/2017-11/2018

Collection Resolution Recovery Analyst, Weiss Wexler & Wornow, Attorneys At Law, New York, NY 5/2012-11/2016

Consultant/Accounting, Weiss, Wexler & Wornow, Attorneys At Law, New York, NY 1/2010-5/2012

Financial Claims Analyst, GCG Risk Management & Safety Consultants, New York, NY &/2006-1/2010

Billing Analyst, GAB Robins, New York, NY, 6/2005-7/2006

Claims Auditor, Team Leader, Hereford Insurance Company, New York, NY 11/2002-4/2005

Reinsurance Accounting Analyst, American United Life Reinsurance/3 years.

E D U C AT I O N & T RAINING

Bachelor of Science in Finance/Associates in Accounting, Minor in English, Long Island University, Long Island,

NY

Certificate in Paralegal Studies, American Bar Association, GPA 3.5, Long Island University July 1994

Training received in the transfer of risk, traumatic brain injuries, orthopedic injuries, spinal cord & neurologic

disorders.

TECHICAL SKILLS

Software: Microsoft Office (2003, 2007, 2013, 2016; Access, Word, Excel, Power point, Outlook.

Operating Systems: Mac/Microsoft Windows (95, 98, XP, Vista) Windows 10, AS400 PBM Database Management.

G EORGE T AYLOR M C D AVID

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