Administrative Assistant Medical

Marlandus Wynn

**** ******* ** ********, ** ***** ?678-***-****?

******.*********@*****.***

CAREER SUMMARY

Motivated, energetic and highly ambitious college graduate with strong work

ethics and professional goals. Worked in multiple pilot programs and

trouble shooting projects to help develop greater efficiency, adherence and

accuracy for client satisfaction. Presented business proposals to establish

stronger relationships with other departments, clients and to create an

overall better work environment. Developed a training/learning curriculum

for new hires. Proficient in Microsoft Office, Excel, and Outlook.

Knowledgeable of health products, services and terminology. Knowledgeable

of FMLA, ADA, STD and State laws. Ability to meet deadlines and perform

successfully within a fast-paced productive environment. Excellent

interpersonal and public speaking skills, communication, presentation and

analytical skills. Vast understanding of medical and insurance terminology.

Lead community outreach projects as a member of the Young Professionals

organization.

EDUCATION

Westwood College

Atlanta, Georgia Dec.

2009 Bachelor of Science Degree -

Criminal Justice

Functional Strengths:

Communication

Strong social perceptiveness while multi-tasking and working with a variety

of clients and customers. Excellent written, presentation, verbal

communication, relationship building and negotiation skills. Worked

internally as a liaison for Fox News.

Research

Detail oriented with strong analytical skills. Completed research projects

involving statistics and causes to improve timeliness and accuracy.

Monitored transitions and work flow to approve efficiency and adherence.

Excellent problem solving, investigative, organization and time management

skills.

Administration

Experience in front office support and operational services. QA work for

clients, customers, and employees to improve quality. Developed a

categorical, electronic, and paper filing system.

Leadership

Supervisory experience as a Day Captain for a major advertising and

broadcasting firm. Lead meetings and presentations for business proposals.

Performed various assignments to represent my team amongst other teams and

departments. Managed daily leadership responsibilities in absence of

Supervisor.

WORK EXPERIENCE OVERVIEW

Analyst, The Hartford Alpharetta, GA June 2011 - Current

Reviewing medical records and healthcare provider certification forms to

support disability and meet the definition of a serious health condition.

Implementing, and verifying changes of high complexity claims to meet

customer and client needs. Managing and applying state and federal

policies, laws and guidelines to ensure no action is taken against a client

while the client is incapable of working. Managing client accounts and

caseloads of 950 plus employees. Prioritizing daily work to make timely

decisions within federal compliance regulations. Identifying problems and

developing quick solutions to reduce escalations to management. Leading

group and solo projects for the department. Implementing solutions to meet

highly complex client, customer and compliance needs. Corresponding with

employer contacts specifically addressing issues that arise with clients

before and after going Live. Holding meetings with clients and business

managers to establish and build better relationships. Coordinating meetings

with clients, brokers, sales representatives and technical contacts to

ensure smooth transitions for new clients. Working with customers and

internal business users regarding operational details, solutions, and

proposals. Mentoring and training new employees on claim practices,

standards and new systems. Working in multiple systems simultaneously.

Claims Specialist, Global Tech Atlanta, Georgia Jan

2009- May 2011

System analysis, system integration and testing, research, and processing

health inquiries for medical, dental, pharmacy and mental health claims.

Researching disputed delinquent account balances. Handled patient insurance

accounts, medical, dental and pharmacy claims for multiple states. Post

Electronic Funds Transfers, patient payments, and make account adjustments

daily. Prepare balancing reports and updating patient information and

demographics. Submitting refund requests, recoupments, or offset payments.

Tracking and processing claims. Researching information and compiling

records to obtain authorizations and referrals. Fax payment reports to

Extended Business Office weekly and verify account information. UB92,

HCFA1500 claim form, and HIPPA guidelines knowledge. Interpretation of

EOB's, MRA's and knowledge of CPT/HCPCS codes. Monitored and controlled

resubmission of denials, rejections and appeals. Planned and implemented

procedures to adjust claims. Managed and approved small to medium sized

billing statements, claims and associated administrative activities to

ensure compliance with laws, regulations, policies agreements, and

contractual arrangements.

Administrative Assistant, Georgia Perimeter College Clarkston, Georgia

July 2006- Jan 2008

Performed clerical duties such as copying, typing various forms of

correspondence (i.e. letters, reports, proposals, forms, envelopes), and

mailings. Served as point of first contact and receptionist. Welcome

students, faculty, staff and visitors, answer general inquiries, and answer

direct telephone calls. Scheduled appointments, planned and made

arrangements for luncheons and meetings; reserve facilities, also

coordinated meals and/or refreshments.

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