Medical Billing Specialist

Kennisha Pickett

*** ******* **** ***. *

Jackson, MS 39211

601-***-**** – Cell

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

OBJECTIVE: To obtain a challenging and responsible position, utilizing the abilities that I have

developed through my past experience and training, with the opportunity for

professional growth based on performance.

EDUCATION: Jackson State University Jackson, MS

College of Business (AACSB Accredited)

Bachelor of Business Administration

Major: Management

Hinds Community College Raymond,

MS

Associated Degree

Major: Microcomputer August

2004

EXPERIENCE:

Sept. 2013 - Present United Healthcare

CLAIMS REPRESENTATIVE

• Outbound Call Center position contacting providers on an as needed basis.

• Review, research, investigate, negotiate, process and adjust claims.

• Analyze and identify trends and provide reports as necessary.

• Perform various complex adjustments for medical claims with the ability to

seamlessly maneuver and manipulate UNET.

• Explain the patient and/or provider liability to providers to resolve billing issues to

prevent escalation to appeals.

• Use fee schedule as a tool for billing inquiries, communicate important information

to providers while obeying the HIPAA and CMS guidelines.

• Exceed production, quality, revenue, and adherence goals to ensure company

turnaround time is met. Ridgeland,

MS

June 2008-April 2013 Cahaba Government Benefit Administrators, LLC (Contractor for Medicare)

CASE ANALYST

• Call Center position handling limited calls per day.

• Responded to telephone or written inquiries from Medicare beneficiaries, attorneys,

or insurance companies regarding information on Medicare secondary payer

liability actions to be taken.

• Experienced with negotiating Medicare and CMS reimbursement methodologies

and reviewed EOMBs for reimbursement.

• Replied to requests for appeals/redeterminations/compromises to previously

received Medicare liens to avoid Congressional escalations.

• Identified mistaken Medicare primary payments using ICD-9 codes to initiate

recovery process in ReMAS to issue correct lien information, provided Medicare

billing info, documented A/R collections, prepared A/R aging reports, and

generated refund checks in Oracle.

• Contacted insurance companies, third party payers, or attorneys to resolve

outstanding Medicare liens and researched claim data to ensure all correspondence

remain in compliance and to prevent delinquency. Ridgeland,

MS

April 2007-June 2008 Region Bank

PROOF OPERATOR

• Created documents/spreadsheets using Microsoft Office, trained new associates on

Regions call center procedures

• Processed NSF payments, performed general mathematical tasks, and used fee

schedule as a tool for overdraft fee charges

• Provided guidance to customers both internally and externally, followed bank

protocols, generated nightly reports of daily transactions processed, operated office

equipment (i.e. computer, fax, printer, & copier

• Processed bank documents by ten-key touch and generated correspondence

advising of account changes.

• Performed monthly Quality Assurance evaluations for employees and monitored

associate’s production metrics. Jackson, MS

May 2003-April 2007 Baptist Health Systems

MEDICAL RECORDS TECH I

• Received, prepped, and indexed discharge charts

• Answered phones

• Read Microfilm

• Filed

• Assisted customers and doctors

• Scheduled and maintained appointments

• Screened calls

• Data Entry

• Verified Insurance

• Electronic Medical Records

• Billing Jackson,

MS

SKILLS: Microsoft Word, Excel, Power Point, Access, Outlook, Internet, 10-Key Calculator

REFERENCES: Available on Request

Contact this candidate