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Customer Service Data Entry

Location:
Philadelphia, Pennsylvania, United States
Salary:
15-up
Posted:
May 17, 2019

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Resume:

SHARON BURDETTE

**** *. **** ******; APT. D*

PHILADELPHIA, PA 19126

215-***-****

ac9ej4@r.postjobfree.com

WORK EXPERIENCE

Mercy Fitzgerald Hospital 06/14-Present

Data Entry-Phlebotomy Darby, PA

Labeling blood tubes with patient name and date of birth

Sending and receiving blood specimens to various medical and clinical laboratory for blood testing

Magee Rehabilitation Hospital 04/19-Present

Billing Specialist Philadelphia, PA

Verifying Inpatient/Outpatient insurance benefits, referrals, precertification and authorization

Follow up claims, payments, denials, appeals and reconsideration on claims

Co-pay, co-insurance and deductibles from patients

Review payments from both remittance and EOB’s for accuracy; process appropriated adjustments and/or payments when necessary; investigate and reprocess denials and partial payments

Billing Claim forms use UB-04 and 1500; Microsoft Word and Excel and Outlook

KesslerTopazMeltzerCheck LLP 02/19-04/19

Data Entry Clerk Radnor, PA

KTMC Attorneys at Law

Entering Account Summary, Schedule of Assets, Purchases, Gains and Losses using Excel software; Printing/Scanner

Technology; professional and detail-oriented, Fast-paced well-known law firm

Acclara Solutions, LLC 10/18-01/19

A/R Specialist Fort Washington, PA

Daily responsible for adjudication of claims; processed within the scope of the Clients(s) contracted services and parameters of available systems (software used-MedHost, Powerchart, Citrix, Relay, Availity, Navinet)

Review and process outstanding claims for various hospital and physicians (Chestnut Hill, Brandywine Hospital, Phoenixville Hospital, Pottstown Hospital, Jennersville Hospital)

Review and process outstanding client accounts receivable as assigned, to facilitate subsequent payment and claims adjudication on a timely basis; working an average of 40 to 50 accounts daily

Perform insurance verification as well as the preparation and submission of electronic and paper claims for various carriers, including, but not limited to governmental and managed care payers

Review payments from both remittance and EOB’s for accuracy; process appropriated adjustments and/or payments when necessary; investigate and reprocess denials and partial payments

Billing Claim forms use UB-04 and 1500; Microsoft Word and Excel and Outlook

Other duties as assign

Holy Redeemer Hospital-Business Office 05/18-08/18

A/R Specialist Follow Up Philadelphia, PA

Collection of hospital convenience charges,

Co-pay, co-insurance and deductibles from patients

Ability to analyze accounts correctly and resolve patient complaints

Concerns in a timely and accurate manner

Excellent and effective customer service skills

Various Insurance Providers Appeals Letter, TDI’s, EOB’s

In addition, COB’s Claim forms for payments

Prepare all hospital business office payments for daily deposits

Maintain the Cashier/Miscellaneous spreadsheets

Communicate patient information to Hospital Billing

Process high dollar claims for Inpatient and outpatient

Various Software use Cerner – Soarian, United Healthcare Portal, Navi-Net

Special projects as needed

CONNECT AMERICA 11/17-03/18

Billing Specialist Broomall, PA

Responsibilities include verifying member use of equipment and service thru various portal

IA Medicaid Portal-Amerigroup & United Health Care

S. Burdette Resume’

Page 2

Make outbound calls to Amerigroup/IA Medicaid clarify member information

Iowa Healthcare Portal-member eligibility, authorization

Various software used-Salesforce, Hsys, Availity Navi-Net

Update member information with Case Managers

Process Rebill & Age Reports

Referring Provider Age and Rebill

Various Insurance Providers Appeals Letter, TDI’s, EOB’s

In addition, Claim forms for payments

CPT Procedure with modifiers ICD 9/10 coding

Partial payment on claim-appeal for full payment on claim

Check authorization for period of member coverage-precertification

Update ledger-billing payment-dates submitted claims-payment received

Filing claims within filing limits

DATABANK, INC. 05/17-10/17

Post Processing Technician Huntingdon Valley, PA

Conduct Electronic-Medical Records quality checks on scanned images in network and on hard drives

Rescan and insert corrections as necessary

Burn backup CD’s as required

Follow instructions and communicate with supervisor or trainer when appropriate

to ensure customer expectations are met

Maintain confidentiality and security of client information per client guidelines

Ability to perform high levels of repetitive motion on a daily basis

Resolve problems promptly, accurately, and in such a way as to prevent future problems

Adheres to quality assurance standards and processes to ensure the highest quality product

Ability to meet attendance and punctuality requirements

Ability to lift boxes weighing up to 40 lbs.

BNY Mellon 12/16-03/17

Data Entry Clerk II Wilmington, DE

Responsibilities include verifying shareholder’s information for possible fraud for Healthcare Share accounts for multiple management companies affiliated with BNY Mellon

Data enters shareholder’s credentials into various company databases to thoroughly complete the verifications process

Creates Initial, Reminder and Liquidation letters to send to shareholders for notification for missing information reflecting their Healthcare Share Accounts,

so that they may provide critical verification info to complete the Customer Identification Process Operates data entry device to input and maintain lists, record, and other data points into an electronic format

Perform daily department tasks such as monitoring email boxes, while creating and updating Excel spreadsheets

Assists in the 90-day compliance review for assurance

Reimbursement Technologies, Inc 12/15-11/16

Advance Denial Follow-Up Conshohocken, PA

Medical Administrative/Accounts Receivable Clerk

(Customer Service/Clerical Associate)

Make outbound calls to clarify doctor’s information

Provided Clerical support for the denials department

Attracts potential customers by answering product and

Service questions

Process Rebill & Age Reports

Referring Provider Age and Rebill

Various Insurance Providers Appeals Letter, TDI’s, EOB’s

and Claim forms for payments

CPT Procedure with modifiers ICD 9/10 coding

Customer Service Medical Biller-Revenue Recovery

Insurance and adjustment identification to ensure proper

account resolution

Appeal Letters, EOB’s

Examine client’s information via Embillz

S. Burdette Resume’

Page 3

Process and Explain (EOB) Explanation of Benefits to Client, Insurance

Companies and Hospitals

Entered and verified abstract data elements

Updated addresses, names, hospital and physician names though Cubs System

Certified Coding Specialist (CCS)

Update and made changes to client insurance, policy numbers and group numbers

CPT Procedure with modifiers ICD 9/10 coding

Place hold on accounts for 30/40/60 days

EmCare 09/15-12/15

Site Billing Coordinator/Hospitalist Horsham, PA

(Assignment Site: EmCare-Horsham, PA)

Review emergency department medical records/charts to ensure that all required information was received in order to determine if documentation

can be submitted to the billing department or considered unbillable due to missing or lack of required information

After reviewing all documentation, update the statuses of all accounts for tracking purposes

Review all emergency discharge information in the company portal for tracking and billing purposes

Wills Eye Hospital 12/14-06/15

Medical Biller & Coder Philadelphia, PA

Collect and sort Superbill Surgical Services

Accountants Receivable-Patient Functions-Charge, Bill and Post

Medical Records-ICD 9/10 Codes and CPT Procedures

Medicare Insurance Billing

Bill and coding for Shields/Levin

ORA & FEMITO coverage

Bay Area Credit 08/12-10/14

Medical Biller Conshohocken, PA

Process and Explain (EOB) Explanation of Benefits to Client, Insurance Companies,

Hospitals and Physicians

Bill variety of Patient claims to Hospital, Insurance Companies, Medicaid and Medicare

Process, Collect and distribute (CSC) Collection Status Changes

Update and make change to Client Insurance, Policy number and group number, place hold

on accounts for 30/45/60 days

Update client information via Embillz

Adjustments and payments made on client accounts, adjustments and payments posted to

Payment/Account Sheet Process Claim forms for Workers Comp, Auto/Motor Vehicles Accidents, and Health Insurance

Update address, names, hospital and physician via Cubs system

Perform Mail/Fax distribution

Provide client’s assistance to internal/external customers efficiently

Monthly coding reports, correct billing/coding errors on report, resubmit with correct codes

CPT procedures, ICD-9/10 CM

Certified Coding Specialist (CCS)

EDUCATION

National Allied Health Registered Certified 06/16-Present

ICD-10 Coding Specialist

American Heart Association 03/18-03/20

First Aid CPR AED

Prism Career Institute-Upper Darby, PA 06/11-05/12

Medical Billing and Coding

GPA 3.56

S. Burdette Resume’

Page 4

EXTERNSHIP:

Vine Street Medical and Associates 225 Plus Hours

Medical Coding and Billing Extern

Accelerate scheduling appointments, MRI, CT scans, X-Rays and Therapy

Efficient filing, charting, copying, faxing and documenting of patient care

Billing and coding via Medisoft and Internet

Receiving incoming calls and messages while running the front desk

CPR and AED Certification

Bloodborne Pathogens Certification

Skills Summary

Availity, Practicum, Zirmed, CPT Procedures, HCPCS, Medical Terminology,

Soarian, United Healthcare Portal, NaviNet, MedHost, Powerchart, Citrix

Hsys, Multi-Task, Medicare/Medicaid Guidelines, ICD-9/10 Coding

Microsoft Word/Windows, HMO’s, PPO’s, Worker Comp

Excel, Access, Lotus Notes, Power Point

Data Entry, Payroll, Accounting, Medical Records, Outlook

Customer Service, Scheduling, Diversity

Scanner, 35-55 WPM, 10-key Calculator skills

Administrative Assistant, Secretary, Professional Presentations

Nationally Registered Certified Coding Specialist

Volunteer Activities

Mentor-Philadelphia Futures, Sponsor Scholarship Program

Volunteer-Core Philly Scholarship Program

Youth Program-Talent Shows, Block Parties, Fundraising

Volunteer-Toys for Tots, Pick-up/Delivery



Contact this candidate