Tara Bell

205-***-****

ad0n1d@r.postjobfree.com

EDUCATION

Jacksonville State University - Jacksonville, AL Dec 2003

• Bachelor of Science in Finance

Gadsden State Community College - Gadsden, AL May 2001

• Associate in business administration

PROFESSIONAL EXPERIENCES

Claims Examiner (Medicare) Apr 2023 - Present

Sutherland Global – Birmingham, AL remote

• Adjudicate medical claims that include analyzing member and provider information, service codes, dates, place and type of service, and hold codes

• Familiar with CPT and HCPCS codes

• Familiar with UB and 1500 claim forms

• Perform Authorization verifications

• Request maintenance on claims

• Responsible for Denial and payment claims

• Process many types of claims including COB’s

• Document claim findings

• Determine pricing for facility and professional claims

• Maintained HIPPA policy

Healthcare Claims Examiner II Jan 2021 - Oct 2022

SS & C Technologies - Birmingham, AL remote

• Adjudicated medical claims which included analyzing member and provider information, service and diagnosis codes, dates, place, type of service, and procedure codes

• Requested maintenance to correct errors on claim submissions

• Processed many types of claims including COB’s, Facility, and Anesthesia

• Documented claim activity

• Performed authorization verifications

• Familiar with UB and 1500 claim forms

• Determined pricing and calculations for facility and professional claims

• Maintained HIPPA policy

• Processed over 32,000 claims

Customer Service Representative Nov 2019 - Feb 2020 Tailored Management - Birmingham, AL

• Reported system errors in the credentialing process to ensure provider's applications are correct and expedited

• Provided Sales Agents with accurate provider data

• Investigated and resolved member complaints regarding providers to maintain member and provider satisfaction

Senior Provider Data Representative Aug 2019 - Oct 2019 Tailored Management - Birmingham, AL

• Conducted system updates in the credentialing process to ensure provider's applications are correct and expedited using QNXT

• Submitted errors to be corrected by Provider maintenance in OnBase

• Completed projects assigned periodically

Quality Control Analyst Apr 2019 - Jun 2019

Staffmark - Birmingham, AL

• Conducted audit reviews of several different loan documents such as applications, credit reports, appraisals, income, and asset documents to determine accuracy

• Worked with formal test plans, tracking, and reporting system defects

• Analyzed data to detect deficient controls, identified transaction components that indicated a potential for fraud or material misrepresentation, and performed sufficient investigative work to confirm or disprove issues that are identified

Office Assistant Mar 2019 - Apr 2019

PrideStaff - Birmingham, AL

• Manually posted payments by cash, checks, and credit card transactions

• Posted daily revenues by verifying and entering transactions

• Summarized receivables by maintaining account receivables, verifying totals, and preparing other reports as needed

• Closed and balanced daily receivables

• Collected debits, cash, check payments from customers Office Manager Dec 2018 - Feb 2019

Alabama City Auto Sales - Gadsden, AL

• Managed contract adherence according to insurance requirements and payment policy

• Implemented a revenue analysis plan for operations improvement

• Implemented a bad debt analysis plan to improve profits

• Received and logged customer payments

• Ensured business equipment operated properly

Auditor I Jan 2018 - Nov 2018

Palmetto GBA - Birmingham, AL

• Completed desk reviews of bad debts for various healthcare providers

• Created working papers

• Reviewed Medicare cost report submissions for the accurate documents

• Analyzed trial balance and financial statements for accuracy

• Requested additional documentation from the provider as needed

• Performed adjustments to the cost report as needed

• Developed detailed recommendations on each audit

• Prepared provider audit results agreements

• Responsible for audit file creations and management Financial Operations Accounting Technician Jun 2016 - Jan 2018 National Government Services - Birmingham, AL

• Performed reviews on credit balance reports for accuracy

• Updated and recorded data for internal controls and tracking

• Requested financial documentation from providers as needed

• Team member of Process Improvement assisting with creating and updating procedures

• Processed claim adjustments for accurate reimbursement

• Maintained deadlines and exceeded production expectations Financial Accounting Technician Oct 2015 - May 2016 Robert Half - Birmingham, AL

• Trained associates on check indexing which included funds verification and requesting refunds for unapplied check receipts

• Guided processors on how to process voluntary claims

• Reviewed and assigned claims to different work groups

• Processed claim adjustments for overpayments

• Performed check indexing for incoming check receipts Cost Report Technician May 2012 - May 2015

Cahaba GBA LLC - Birmingham, AL

• Reviewed Medicare cost reports for acceptability verifying the accuracy of original files by comparison to provider files

• Reviewed cost reports for bad debts

• Calculated and processed tentative and final settlements for various provider types

• Applied auditor adjustments in the audit system

• Prepared correspondence disclosing discrepancies for the provider to correct

• Prepared tentative and final settlement financial calculations and correspondence

• Assigned and reviewed assignments for incoming cost reports

• Analyzed multiple databases and reports to clear up discrepancies

• Suggested new procedures for improved processes for efficient workflow

• Maintained deadlines

Asset Management Analyst Dec 2008 - May 2012

Cahaba GBA LLC - Birmingham, AL

• Wrote and updated department policies and procedures

• Responsible for the movement and safeguard of company assets

• Responsible for the distribution and collection of employee-company asset agreements

• Responsible for the updating and maintaining requests through IT Ticket System

• Assisted with the monthly depreciation and disposals in the accounting system

• Created monthly asset reports for the CFO and IT

• Created and maintained all assets in the tracking system

• Performed quarterly cost center audits

• Maintained a weekly ledger of assets received

• Conducted annual audits on IT equipment and other assets

• Communicated with managers to conduct annual reviews and general asset tracking concerns

• Completed special projects- RHC Final Settlement Verifications, CSA File Reconciliation, Cahaba Printer Consolidation, Assigned Laptop Verifications, CAM ISO Process Documentation, and Independent Clinical Lab Site Verifications

REFERENCES

Tiffany Tatum, Manager – ad0n1d@r.postjobfree.com Tammy Evans, Former Supervisor – 717-***-****

Zolanda Mock, Former Co-worker – 205-***-****

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