Customer Service Data Entry

Cheryl A DeTemple

*** ****** ******

Huntington, WV 25705

Cell: 928-***-****

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

Career Focus

Looking for a position that will utilize the skills and experience I already possess, as well as allow me the opportunity to

continue learning.

Summary of Skills

Customer service Medical terminology

Strong organizational skills Compensation/benefits administration

Listening skills Recruitment/staffing

Claims Data Entry Interviewing

MS Windows proficient Strong verbal communication

Attention to detail File/records maintenance/archiving

Employee training and development Reports generation and analysis

Business correspondence Quality assurance

Insurance Claims Adjudication Policy/program development

Current Procedural Terminology (CPT) International Classification of Diseases (ICD.9CM)

HCFA Common Procedure Coding Systems (HCPCS)

Accomplishments

• Computer Proficiency

• Created PowerPoint presentations that were successfully used for business development

• Database Maintenance

• Assisted in the managing of the company database and verified, edited and modified members'

information.

• Process Improvement

• Created new departmental procedures manual.

• Assessed organizational training needs.

Professional Experience

Radiology Receptionist

Cabell Huntington Hospital, Huntington WV February 15, 2021 to Present.

Check in Radiology patients, provide reports and images to patients/ providers/facilities, schedule patient appointments, etc.

Admin Staff Support

Elwood Staffing/Memorial Hospital – Colorado Spring, CO June 22, 2015 –

May 2020

• Onboarding Traveler individuals, posting positions, job offers, tracking compliance requirements to ensure that all

required documents are present (i.e., licenses, health exams), create and maintain spreadsheets of current and past

Travel individuals, New Hire Orientation, assist with ShiftWise employer tracking system questions, generate reports

for upper management, act as liaison with hiring agencies, etc.

Manager Provider Data December 2012 to

July 2014

HMSA – Honolulu, HI

• Manage a staff of 16 employees with the Provider Data Unit. Update and add new providers record into the companies

4 database systems, complete employee performance evaluations, draft documents for system enhancements, respond

to provider and other department’s inquiries, act as department representative in projects and policy changes, etc.

Legal Secretary November 2010 to

December 2012

Mohave County Criminal Justice Services – Kingman, AZ

• Prepared motions & briefs for filing in Courts for Appellate Defender, open & distribute case assigned to the Public

Defender's office, enter billing data for legal cases administrative support to Appellate Defenders and Criminal Justice

Department, prepare contracts for contracted Public Defenders, telephone duties, filing, etc.

Program Service Evaluator, III January 2007 to

June 2010

State of Arizona – Kingman, AZ

• Determining eligibility for State Medical, Food Stamp & Cash Assistance benefits. Explain & follow State &

Federal regulations, customer service, computer file entry & maintenance, assigned hospital worker - collect

medical applications, interview clients & disseminate applications to proper offices, format cases for scanning

into database system.

Administrative Assistant/HR Technician February 2004 to

November 2006

City of Kingman – Kingman, AZ

• Human Resources - recruitment, new hire paperwork and orientation, training & presentations, COBRA & FMLA

tracking, benefits enrollment and administration, salary surveys & employment verifications, insurance billing

reconciliation and payment, payroll.

• Administrative Assistant in City Clerk's office- disseminating information to the Mayor, Council, staff, general public

and other agencies on City programs, activities and policies; business license application review and approval process;

City elections; records and computer file maintenance; development of flyers, newsletters, agendas, and minutes;

clerical support; customer service; assist Human Resource Department with reference verifications and interview

scheduling, flyers, job postings and advertisements, advertisement tracking and payment authorizations, assist with

Health fair, assist with luncheon preparations, bank deposits, etc.

Safe Home Network Coordinator July 2003 to

February 2004

Interagency Council – Lake Havasu City, AZ

• Safe Home Network Coordinator, plan and coordinate training sessions and monthly meetings, filing, database

entry, typing, written communications, case manage clients in transition housing, develop flyers and pamphlets

for education/information purposes, appointment scheduling, educational presentations, work with internal and

external departments, public groups and governmental agencies, etc.

MIS Database Administrator February 2001 to

April 2003

State of Montana – Helena, MT

• Manage and operate the job training participant information database; provide programming and support services;

training and policy direction to approximately 28 service providers statewide and two local workforce investment

areas; analyze and screen data to identify aberrations or potential problems with the date; generate reports to the

US Dept. of Labor, Governor, legislature, state and local workforce investment boards, public, and service providers;

provide training and technical assistance to internal and external customers regarding federal and state laws,

regulations, program functions, goals, etc.

Call Center Representative/Supervisor February 1999 to

February 2001

New West Health Services – Helena, MT

• Answer benefit questions; address claims problems; supervise call center workflow; system testing; new product

review and implementation; presentations; policies and procedures development, updates and revisions; claims

auditing; work with internal and external departments, public groups and governmental agencies; provide training to

internal and external entities; maintain employee files and yearly evaluation assessments; reporting inventory and

production statistics; payroll time sheet verification; employee counseling; and disciplinary actions.

Administrative Assistant / Phlebotomist January 1998 to

February 1999

St. Patrick Hospital – Missoula, MT

• Patient registration; front office reception; order laboratory tests; print and distribute laboratory reports; write

compliance policies; deliver lab results to physician offices; receive telephone laboratory orders; phlebotomy; EKG's,

etc. .

Family Support Officer January 1997 to

July 1997

Butte County Family Support Office – Oroville, CA

• Locate, request and conduct interviews relating to child support services; resolve questions of paternity; negotiate

agreements for support payments; correspond with a variety of governmental and private agencies; obtain facts and

prepare cases for submission to investigators/attorneys for potential prosecution; read, interpret and explain laws

and regulations pertaining to family support services; generate legal documents; provide testimony in court, etc.

Medicare Blue Shield of California – Chico, CA

September 1982 to November 1996

• Entry of claims into processing system; examining claims for completeness; develop for missing information and

review diagnoses to determine payment and deny non-payable services.

• Audit claims processed for accuracy and completeness; conducted training classes for new and promoting employees;

special projects (i.e., writing of RFP’s, development of interim guidelines for problem situations, assist with the testing

of new systems, etc.); assisted supervisors; and developed and implemented the alternate claims processing shift.

• Managing the workflow of 13 to 30 processors to maintain productivity and timeliness; maintain employee files

including quality and production records and yearly evaluation assessments; daily reporting of inventory and

production; payroll time sheet verification and submission; employee counseling and disciplinary actions; review

production standards; dealing with system problems; Medicare Bulletin review; development of desk level procedures

for HV transactions and batch control, etc.

• Train new and promoting employees into processing functions; guideline clarification; update processing manuals;

review Medicare Bulletins and Special Notices for content and clarity; teach medical terminology; assist

providers/beneficiaries with billing questions and/or claims problems; developed and implemented the Consistent

Auditing Program, etc.

• Monitor provider billings to ensure compliance with government regulations; research cases using CRT/MDT/Micro-

fiche readers and PC’s; train new employees in the unit; supervise employees in the absence of the unit supervisor;

special projects (i.e., Common Working file proposal); internal/external presentations regarding the functions of the

Provider Monitoring Department and annual budget preparation.

• Supervise 14 analysts and assistants; research and develop potential Medicare fraud and abuse cases; work with

internal and external departments/public groups/and governmental agencies (i.e., OIG, HCFA; FBI; providers and

beneficiary communities, etc.); provide expert testimony in trials and hearings; provide training to internal and external

entities; maintain employee files and yearly evaluation assessments; reporting inventory and production statistics;

payroll time sheet verification; employee counseling and disciplinary actions; Medicare Bulletin review; development

of desk level procedures manual for PSU functions; participated as the fraud authority at provider/beneficiary seminars

for Northern California Medicare and annual budget preparation.

Education

Butte Community College

Oroville, California, US

Wildlife Biology

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