Brenda Washington

315-***-****

PROFESSIONAL SUMMARY:

Self driven professional, with a great deal of experience working in diverse work environment performing medical claims, customer service and administrative tasks. Motivated team player that works well independently, with minimal supervision. Detailed oriented, capable of working in a fast pace environment performing multiple task efficiently and completing them in a timely manner. Excellent communications skills written and oral with a knack for asking probing questions in order to make sure the customer/clients needs are being met. A dependable, loyal, self starter eager to work for your company.

SKILLS:

Microsoft Windows (3x, 4x, NT and 2000), Pro/Server, Word 97, MS Office Pro 2000, Novell, Cisco, MS-DOS (Versions 1-8), ACT, Goldmine, Customer Service, Collections, Claim Processor/Analyst, ICD-9, Diamond, Medisoft Software, Type (35-45 wpm), Data Entry (10000+ KPH), File Clerk, Medical Billing/Coding, Data Analyst, Receptionist, Accounting, Claim Adjudication.

PROFESSIONAL EXPERIENCE:

K-Force 5/2012-6/2012

John C. Lincoln-North Mountain

Health Information Technician II

Responsible for ensuring medical records are completed based on HIPAA guidelines and standards. Responsibilities included:

Assembled all types of medical records and analyzes the records for documentation deficiencies Assisted physicians in completing records and filed completed records Answer the phone and responds to Fax requests. Giving faxes to Hospital staff Respond to requests for information requiring patient authorization or requests exempt from authorization. Requests given to Hospital staff

Analyzes medical records for deficiencies

Analyzes medical records for audit

Utilizes the computer systems to input and update record deficiencies; verifies transcription status and prints documents as necessary

Assists with the physician status and profile maintenance regarding record deficiencies in accordance with established policies and procedures Fax medical records for Hospital staff

Assists in investigating issues regarding status of record deficiencies and updates the database Copied files for Audit; and copies given to Manager of HIM Department Managed and organized filing of medical records

Filed loose papers into records and made sure HIPAA guidelines where being maintained Organized Dr’s Open lists for any open accounts and those accounts put into folder for Dr’s signature

SOS Staffing

December 2011-Febuary 2012

Cricket-Greeter

Greeted and entered customers into database for their needs. Assisted them with payments and Customer Service on phone needs.

March 2011-May 2011

Halycon Search Solutions

Adena Medical Center

Chillicothe,Ohio

Data entry of Claims for Medical Center.

Corestaff Services (Temp)

January 2010-Febuary2010

Apria Healthcare

Collections Rep

Called on Prescriptions that needed to be signed and dated by Dr. for Billing Department. Called patient’s if unable to get a hold of Dr. Worked on Queue’s that where 60 days or more. November 2009-December 2009

Shutterfly

Photo Cutter/Processor/Shipper

Cut photo’s 4x4, 4x8’s. Processed and shipped orders to customers. Verified shipping address and gave to supervisor if address or order was wrong Verified that picture quality was correct or resent for redo.

June 2009-August 2009

Apria Healthcare

File clerk/ data entry clerk/ prep

Pulled medical files, verified labeled correctly, and sent to be scanned. Data entry of medical files and records. Verified Accuracy of records once scanned.(For correct patient file scanned and not another patients. HIPPAA guidelines); after scanned processed file for accuracy. For data archiving of patient’s file I verified that patient file was completely scanned for records department. Once scanned properly was sent to shredder area. If needed to be rescanned, Rescanned file sent to that area ( if scanned upside down, errors in scanning, etc.) Prep of medical charts from branch offices and site location; so they can be scanned and file data archived. Verified that file was correct. Account number and patient record matched and prep file. Sent to Imaging for scan.

Rose International ( Temp )

Bank of America

Support Service Specialist

Chandler, AZ

February 2009-April 2009

Check and match mail to the corresponding county by compliance date. Identify and sort incoming overnight courier, interoffice and US mail-distribute appropriately. Loan payoff papers. Able to use appropriate technology for processing, research and validation of information regarding loan papers. Lift/shift work boxes weighing up to 35+ lbs. Synergy

Health Facilitator

Aetna

August 2008-October 2008

Insured accurate and efficient response to claims inquiries; including the maintenance of good provider relationships.

The review and research of claim adjudication, resubmission and adjustment/correction to claims as required.

Receive inquiries, from providers regarding claim status by telephone; answer call within established company standards.

Maintain an accurate online communications call log in accordance to department guidelines. Analyze telephone communications for proper course of action (i.e., grievance or resubmission) and necessary research.

Determine if adjustment is warranted; take appropriate action as defined by department standards and policies.

Review history of claim in question; research particulars; contact appropriate personnel to verify information.

Identify and report issue trends in order to minimize future claims process issues. Develop, establish, and maintain a work priority system to ensure daily and heavy workloads are fulfilled.

Maintain minimum telephone and claims processing standards. Preserve strict confidentiality in regards to all member, provider, and contract service information, including provider Federal Tax ID numbers, DEA numbers, and credentialing information.

K-Force

Phoenix, Arizona

March 2008-August 2008

HIMS Imaging Specialist / HIMS File Clerk (Temp)

Verified and reviewed Medical Imaging Records through Imaging Software at Maryville Hospital. If imaged incorrectly re-sent to agent for resubmission Reviewed Imaged Records for accuracy, before records sent to shred bin Medical Records File Clerk (Temp)

Filed records and assembled them for Mercy Gilbert Hospital in the HIM department Pulled files for Doctor’s and Staff at Hospital, for review of charts and for sign off by Doctor’s Sent letters to Provider’s regarding their status with Mercy Gilbert Hospital Magellan Health Services-National Imaging Associates Authorization Representative

Phoenix, AZ

June 2007 – November 2007

Received pre-authorization requests for designated ASO accounts from referring physician offices via telephone, inputting them into Informa system. Referred cases to the clinical or medical departments for review when appropriate. Elicit assistance/support from the Review Nurse or Medical Director to process registration requests.

Provided information to referring physician offices regarding network imaging providers. Spoke with members, referring physician, staff and imaging providers to answer questions regarding initial or pending authorization requests. Maintained a log of all telephone interactions with referring physicians/rendering providers. Allstaff Services

Phoenix, AZ

January 2007 – March 2007

Medical Billing and Coding Specialist/Data Analyst/Receptionist/ Data Entry Specialist (Temp) Administrative assistant at a construction company; maintained files, answered phones, sorted mail, processed data into the system, faxed paperwork and assisted clients and potential clients of the company

Medical Coding Specialist for medical orthopedics office; called and billed Insurance companies for services

Performed data entry and clerical for trucking company Mystaf

Phoenix, AZ

February 2007 – April 2007

Data Analyst (Temp)

Entered records into the database for a Military Facility Verified that data was correct from paperwork to the inventory on hand Coding Verification Specialist (Temp)

2006-2007

Verified coding processed correctly for HIBCC

Called doctor's offices and re-billed claims electronically if needed. Wichita Falls, TX Claims Processor (Temp)

2002-2003

Processed medical claims for hospital claims department Verified that claims where being billed properly and on time Claim adjudication; fixed any errors that occurred and re-billed claim to correct client and with correct codes. Using Diamond Software.

TRC Staffing / Pearson Digital Learning

Phoenix, AZ

October 2006 – December 2006

Collections Specialist (Temp)

Called schools in regards to outstanding balances on their accounts and attempted to set up some form of repayment for Pearson Digital Learning Verified payment arrangements via phone and email. Collected funds that were also Government funded

TRC Staffing / Banner Good Samaritan Hospital

Phoenix, AZ

August 2006 – October 2006

The City of Hope

Verified accounts for past due amounts and Insurance. Called for payment of claims from 30-180 days past due.

Corporate Job Bank/ Pearson Government Solutions

Phoenix, AZ

March 2006 – August 2006

Medicare Specialist (Temp)

Took calls from Medicare recipients who had questions about Medical and Drug coverage Talent Tree Temp Agency

Phoenix, AZ

March 2005 – March 2006

Claims Processor (Temp)

Input medical claims and coded them to be billed to correct patient Insurance for a local Hospital

File Clerk

Filed medical record for Hospital in Tempe, AZ.

Made and filed medical records for Records Department. Accountant for Tax Firm

Filed and Prepared Taxes for Trust Accounts

University of Phoenix

Phoenix, AZ

November 2004 – March 2005

Enrollment Counselor (Online)

Inbound/Outbound calls regarding student enrollment, guidelines and procedures for class Student verification on financial obligations and course criteria. • Account user from start to finish of the Students academic year with the University From enrollment to Financing to any Collections the student has with the University Apple One Temp Agency

Phoenix, AZ

August 1998 – November 2004

Claims Processor (Temp)

Inputted Medical claims from various hospitals into database ICD/9 Knowledge and medical terminology

(Claim Adjudication). Using Diamond software

Neutron Industries

Phoenix, AZ

May 2003 – September 2003

Sales Associate

Inbound/Outbound calls selling cleaning supply products to Businesses Account management and customer satisfaction

High-Tech Institute

Phoenix, AZ

February 2001 – July 2001

Laboratory Assistant

Assisted students with assignments and labs

Tutored students that needed assistance in certain areas Discover Card Services

Phoenix, AZ

February 1999 – July 1999

Customer Service Representative

Account inquiry and resolved any errors and issues that arose, speaking with Merchants if needed

Balance Transfers, and credit increases and decrease requests Bank One

Phoenix, AZ

August 1998 – February 1999

Collections/Customer Service Representative

Inbound/Outbound calls on accounts that were delinquent Took payment arrangements on accounts

Medical Claims

Phoenix, AZ

1996 – 1999

In house medical coding thru third party agency.

Inputting medical claims and processed them for billing to correct Medical Insurance Company Claim adjudication of AHCCS medical claims

In-house medical coding and claim processing of medical files in database EDUCATION:

High-Tech Institute

Associates of Occupational Studies in Computer Networking and Informational Technology.

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