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Medicaid Billing Specialist

Location:
Richmond, Virginia, United States
Posted:
October 06, 2016

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Brooke L. Williams

** ***** ***** ******. ******** Springs, VA 23075

(C) 804-***-**** Email:acwx64@r.postjobfree.com

Summary of Qualifications

Takes personal responsibility for the quality and timeliness of work and achieves results with little oversight.

Adapts to changing business needs, conditions, and work-related responsibilities.

Wide experience in call center supervision of Medicare & Medicaid health insurance.

Possess excellent coaching, motivational and leadership skills. Set performance goals to meet customer expectations, efficiency levels and quality assurance standards.

Shows insight into the root-cause of problems. Creates a range of solutions and courses of action.

Clearance

United States Citizen

Experience

Universal Health Services May 2015- Present

Medicaid Billing Specialist

Completes all third party electronic and manual billing timely and accurately in accordance with appropriate rules and regulations.

Completes all payer specific edits identified through the billing system

Resolves issues associated with incomplete claims including follow up of non transmitted claims

Submit adjustment claims to Medicare/Medicaid through use of online systems

Attaches appropriate documents when billing manual claims including ER reports, itemized bills, implant invoices and other medical records.

Bulk mails all manual claims to individual payers daily

Works all daily reports as assigned

Records daily productivity of claims billed and assures proper documentation in the notes of the patient accounting systems

Completes all monthly required in-services and educational training as required

General Dynamics Information Technology

Supervisor, Customer Service October 2012 – May 2015

Developing/training, coaching, motivating, retaining, and evaluating qualified staff.

Set clear, meaningful, challenging, and attainable goals and expectations that are associated with those of the business. Present information clearly, concisely, and logically.

Analyze daily reports to coach and develop trending behaviors that negatively impact the business.

Review, adhere, and implement contractual requirements, policies, and procedures established by Centers for Medicare and Medicaid (CMS).

Monitor and manage employee attendance and adherence to schedule.

Complete and deliver monthly, quarterly, and yearly employee performance evaluations.

Provide coaching and effective feedback to ensure employees meet business expectation.

Ensure employee payroll timesheets are accurate, signed, and approved.

General Dynamics Information Technology

Senior Specialist, Customer Service April 2007 – October 2012

Handle CSR/ caller inquires at high call volumes.

Attend weekly trainings and team meetings to review policy or procedural updates.

Adhere to schedule and pre-scheduled breaks.

Helps create a work environment that embraces and appreciates diversity.

Review and follow all contract requirements, policies, and procedures.

Maintain personal attendance by planning time off in advance.

Asks for and uses feedback to improve performance.

Seeks and acquires new competencies, ideas, and information that will improve effectiveness on the job.

Avid Medical Inc.

Production Worker October 2004 – June 2005

Assemble Medical Trays for Hospital Projects

Operate Machine to properly seal products without any infectious material being able to enter.

Prepare kits to be distributed to various hospitals.

Check lot numbers, expiration dates, and vendor codes.

Richmond International Airport

Custodial Services September 2005 – January 2006

Maintain a safe and sanitary work environment for office staff and airline passengers.

Heavy housekeeping of office suites and airport terminal.

Debbie Staffing Agency, Sonoco Inc.

Production Worker June 2005 – September 2005

Prepare various packages on an assembly line for delivery.

Comply with all safety policies, rules, and regulations.

NAACP National Voter Fund

Administrative Assistant June 2004 – September 2004

Register eligible citizens to vote.

Data entry.

Education

High School Diploma 2004 -Charles City High School, Charles City VA

Medical Assistant 2005 - Richmond School of Health and Technology

Early Childhood Education (present) - J. Sergeant Reynolds Community College

Certifications

Medical Assistant

BCC Lean Six Sigma Yellow Belt courses 1-5 Certified

HIPAA

Technology

Operating Systems

Next Generation Desktop (NGD)

Microsoft Office 2007

Aspect/ Empower

Behavioral Analytics

Avaya/ RTA

Attendance Database

References

Available upon request



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