Customer Service Administrative Assistant

Ericka McElwee

**** ********** **. ******* ** ***88 . 832-***-**** ********@*****.***

Objective

To obtain a position that exercises and challenges my skills and

abilities. This position will also contribute to my continued growth and

success in the medical field.

Education

WMCAT, Grand Rapids, MI

Medical Billing & Coding, 2010

Davenport University, Grand Rapids, MI

Bachelor of Applied Science, Systems Analyst/Applications Development,

2008

Skill Highlights

. Proficient in Microsoft Office (Power Point, Word, Excel, Visio,

Access)

. Basic Coding (3M, ICD-9, CPT

. Knowledge of HMOs, Medicare and Medicaid

. Mysis, Accupost, WebXtender, Cerner, Epic (Hospital & Ambulatory),

MediPac, QNXT, Zoll

. Medical Terminology

. HIPPA

Professional Experience

Parallon, Houston, TX

Collection Specialist, 07/2013-Present

. Responsible for investigating third party reimbursement, delinquent

accounts, collection method, all of which require strong analytical

and problem-solving skills.

. Compiles demographic information, along with procedure and

diagnostic codes and fees, and accurately and completely enters it

into the computerized billing system.

. Generates and distributes computerized claim forms and statements.

. Research claims delays by contacting physicians, employers,

parents/patients,

Federal /state/local agencies third-party carrier, and other persons

to resolve issues preventing payment.

. Manage outstanding claims with individual physicians in conjunction

with determination of outstanding claims (i.e., billing members,

appeals, collections placement, write-offs, adjustments)

. Develops working relationships which includes open communication

channel with other members of the department, insurance companies,

public aid personnel, and physicians.

Molina Healthcare, Houston, TX

Member Service Rep II (Temp), 10/2012-04/2013

. Evaluate the accuracy of provider charges, including dates of

service, procedures, level of care, locations, diagnoses, patient

identification and provider signature

. Strictly follow all federal and state guidelines for release of

information.

. Complete appeals, file and submit claims.

. Submit refund requests for claims paid in error.

Life EMS Ambulance Services, Grand Rapids, MI

Customer Service Rep, 09/2011-07/2012

. Verify patient insurance benefits

. Post and reconcile insurance and patient payments

. Verify correct ICD-9 and CPT codes

. Follow-up with Manage care, Government and Commercial insurances

. Audit accounts for possible appeal, adjustments, and/or write-off

. Contact guarantor regarding insurance denial of claims or patient

portion.

. Process insurance and/or patient refunds.

Business Exchange, Grand Rapids, MI

Office Manager/Administrative Assistant, 06/2008-07/2012

. Support a group of busy financial and investment professionals with

administrative support, scheduling meetings and appointments

. Organize and implement employee incentives, events and morale

enrichment activities

. Handle cash flow, banking and internal bookkeeping

. Communicate with city officials, vendors, customers and employees

. Create documents, reports and presentations using MS Office and

managed database

Spectrum Health, Grand Rapids, MI

Collection Specialist/Biller, 03/2010-06/2011

. Verify patient insurance benefits

. Ensures that proper authorization or referral is collected from each

patient

. File claims daily and follow up with claim status

. Submit pre-authorization / claims

. Post insurance EOB's and payments to patient accounts

. Audit past A/R reports

. Verify correct ICD-9 and CPT codes

. Collect outstanding balances on patient accounts

Foremost Ins, Caledonia, MI

Help Desk Analyst, 03/2004-12/2009

. Provide computer hardware and software support.

. Research and troubleshoot problems using available tools such as the

help desk knowledge base and remote control.

. Manage, update and maintain the help desk problem, inventory, client

and

knowledge databases

Contact this candidate