Customer Service Medical
Resume:
Gwendolyn Davis ? ***** Rockside Road #*** ? Bedford Hts., OH 44146?
Skills and Qualifications
> Experienced administrative assistant and human resource
> Excellent interpersonal and customer service skills
> Microsoft Office, Word, PowerPoint, Excel, AS/400 database, HRIS,
ECS, PCC, Benefast and Claimfacts systems, 40 WPM and all office
equipment
> Management, training, team player, organization skills, HIPAA, health
care insurance experience and all general office duties.
> Ohio Public Notary
Work Experience
Villa St. Joseph Rehabilitations Garfield Heights, OH
Medical Records/Coder (March 2014 - August 2014)
. Medical Coding for all diagnosis
. Daily census
. Filing and sorting doctor's prescription orders
. Auditing patients discharges files
. Handle all audits inside and out
. Operating phone systems and receptionist duties
. General filing, updating and administrative duties
Brookwood Retirement Community Cincinnati, OH
Medical Records/Coder (January 2012 - March 2014)
. Medical Coding for all diagnosis
. Review and analyzed medical records
. Keep ECS system update with admits and discharges
. Keep all medical records updated and thin out charts
. Handle all audits inside and out.
. Work closely with MDS coordinators and insurance carriers
.
Hamilton County Board of Elections Cincinnati, OH
Trainer (March 2010 - November 2011)
. Trained poll workers on the fundamentals of election/voting procedures
and the use of trouble shooting the equipment.
Loving Arms Day Center Inc., II Cincinnati, OH
Human Resource Manager (February 2006 - October 2012)
. Prepared payroll notices for benefits and new employees and process COBRA
for terminated employees, process medical dental and 401k benefits for
annual benefits negotiations, along with maintaining HRIS system.
. Achieved all administrative duties
. Achieved policies and procedures for customers and employees along with
customer service duties. Research human resources law and regulations.
. Achieved moral building, assisted with work scheduling, assisted with bi-
weekly vouchers for payment.
Kaplan Higher Education, Cincinnati, OH
Instructor (October 2008-January 2010)
. Trained students in coding, reimbursement and medical billing.
. Instructed on the use of the ICD-9CM, CPT, CDM, RVS, PPS, DRG, EDI and
Medicare-Medicaid HCPCS manuals/procedures.
. Instructed on how to review/analyze medical claims in order to know
diagnosis, procedures, pre-existing, pre-determination, medical
necessity, usual customary and reasonable, medical necessity; check
eligibility; how to read and pay insurance benefits, PPO, HMO,
Medicare/Medicaid Self-funding, co-pays versus non co-pay plans.
. Instructed on how to be a professional working in the medical field using
ethic, etiquette and morals at all time.
Union Institute and University Cincinnati, OH
Benefits Coordinator (June 2002 - November 2005).
. Benefits administration with an outside TPA, reporting, reconciliation of
billings, and claim resolutions.
. Monitored, and processed employee tuition waivers; assist with processing
compensation adjustments and prepared external reports.
. Maintained maintenance of the HRIS system, new hire orientation,
administration of benefits, employment verifications, worker's
compensation administration. In addition, responsibilities included
accounts receivable, purchasing administration, and other office duties
with office support to all.
August Groh & Sons, Inc., Cincinnati, OH
Human Resource Manager/Administrator (January 1998 - June 2001)
. Interviewed applicants; processed payroll; monitor drug test results and
police reports; coordinated with customer service and maintained training
for all employees.
. Processed medical, dental, and 401K benefits; distributed COBRA
information to terminated employees; and maintain HRIS system
monitor/maintained all employee vacations/holiday.
. Conducted Job Fairs and training.
Pacific Mutual Insurance Co., Ft. Wright,
KY
Manager/Supervisor (February 1981 - January 1997)
. Managed 23-32 employees for large self-funding and conventional accounts;
maintained daily operation of claims processing unit; customer service
unit, auditing, analyzed unit workflow to determine business needs,
development and performance management.
. Excellent and very knowledgeable in all claims processing, ICD-9, DRG and
CPT coding procedures.
Education and Training
. Union Institute and University, 2005 - 2007
Major Area of Study: Human Resources/Business Administration
. University of Cincinnati, 1980 - 1982
Continuing Education, Bookkeeping & Accounting
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