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Customer Service Quality Control

Location:
Albany, NY, 12210
Salary:
Negotiable
Posted:
November 13, 2023

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Resume:

Latonya L. Jackson

* **** ****** ***. *-*

Albany, New York 12210

Cell 518-***-****

ad03vi@r.postjobfree.com

Objective: To obtain a position in the Medical or Customer Service field with advancement opportunities and flexibility.

Summary of Skills and Education:

Customer Service Medical Insurance

Internet/E-mail Data Entry

Written/Oral Communication skills Medical Terminology

Ability to problem solve ICD-9-CM

ICD-10-CM CPT coding

Computer literate Call Center experience

Ability to work with diverse population Filing

Ability to multi-task Faxing/Copying

Employment Experience:

Strategic Solutions Management, Medical Billing Specialist II, Clifton Park, NY October 2016-Present

Updating Medical Insurance, completing E-bills, Adding/Modifying CPT codes submitted on claims daily. Completing patient records via EMR system. Manually updating and submitting corrected claims as applicable. Submitting Triages to providers office as a communication tool. Sending weekly reports to providers office via secure e-mail. Completing monthly reports per Accounts Receivable goal set each month. Obtaining patient payments and submitting for processing.

Appleone Employment Agency (Maximus), Quality Control Specialist, Albany, NY February 2013 – October 2016

Responsibilities: Responsible for peer evaluations of completed NYS Medicaid and Family Health Plus renewal applications and missing information documents for accuracy in accordance with Federal and State regulations and department approved policies and procedures, Entering and submitting error findings using department specific Quality Control tools, completing the renewal processing for all inaccurate renewal applications and missing information tasks reviewed, providing feedback to quality control supervisor(s) giving specific reasons for variances, and respond to dispute findings when necessary, meeting and maintaining quality control standards as set by quality control department, remain up-to-date on policies and procedures as set by the quality control department and performing other duties as assigned by management.

Other Employment:

All-Metro Healthcare, Personal Care Aide, Albany, NY July 2003 - May 2008

St. Catherine's Center for Children, Program Aide, Albany, NY March 2004 - November 2006

Anytime Homecare, Personal Care Aide, Albany, NY April 2003 - March 2004

Educational Background:

Hudson Valley Community College, Troy, NY May 2014 – Present

Pursuing Health Information and Technology Degree

Branford Hall Career Institute, Albany, NY May 2007-May 2008 Medical Billing Diploma



Contact this candidate