Follow Up Customer Service
Resume:
RHASHECA PARKER
PROFESSIONAL EXPERIENCE
CHANGE HEALTHCRAE
A/R Specialist Remote (May 2022-Current)
Billing and insurance follow-up on unpaid claims.
Billed/ Rebill electronic, or hard copy claims.
Prepare and send written appeals with appropriate documentation.
Review all insurance correspondence daily to arrive at appropriate claim resolutions.
Review EOBs for accurate contract/non contracted payments.
Call all payor (BCBC, Cigna, UHC, Aetna etc.) for claim status as needed.
Monitored all medical callbacks as needed.
Update the patient account record to identify actions taken on the account (communicate clearly and concisely in writing).
Scanned and stored all patient insurance documents and medical history records with accuracy and confidentiality.
DaVita
Health Information Coordinator (May 2019- May 2022)
Complete timely updates and follow-up on assigned accounts, in a compliant manner.
Identify trends and their root causes within assigned inventory.
Assist with administrative duties fundamental to successful project operations.
Maintains an appropriate level of productivity, as defined by project guidelines.
Process and maintain data within patient’s records.
Coordinators process and maintain private patient information in DaVita database.
Create Job Aid according to DaVita guidelines.
Worked on various projects related to HCPCS & CPT (Kazier, Crown Web, HEDIS)
DSI RENAL
Cash Posting Specialist (Sept 2017-Jan 2019) (contract)
Accurately enter required information (non-clinical and structured clinical data) into computer database.
Review structured clinical data matching it against specified medical terms and diagnoses or procedure codes (without the need for interpretation) and follow established procedures for authorizing request or referring request for further review.
Attached incoming information to CMCS database and follow established procedures for distributing information for further review.
Update customer accounts when payments are received.
Resolve any errors in calculations and billing.
Calculate and maintain records of the amount of money customers owe a company.
Answer calls from physician offices, hospitals, and patients using exemplary customer service skills.
COMPREHENSIVE PAIN SPECIALISTS
Authorizations Dept. Team Lead (September 2014- Sept. 2016)
Answer calls from physician office, adjusters, and patients using exemplary customer service skill.
Assist with billing department to send out claims to Medicare and Medicaid.
Review structured clinical data matching it against specified medical term and diagnoses or procedure codes and follow established procedures for authoring request or referring request for further review.
When provider has applied signature to chart review, send to team therefore reimbursement can be applied to physician account.
Requests that the adjuster sends a return fax containing approval, or denial within 5 business days, and may also answer any questions regarding the claim data.
Initiates follow-up calls beginning with the oldest fax requiring follow-up and will repeat follow-up calls until fax is returned, or project timeline ends.
Contact Cyber Security Control Officer (CSCO) to request release/resolve any issues if the fax is not released within 24 hours.
Process requests for data by adding and correcting entries into a specific database or computer application.
Keeping track of received data and source documents. Compiling, sorting, interpreting and verifying data to be entered. Schedules approve authorization for eval/ treat, injection, medication etc.
Review error reports and enter corrections into database. File and route source documents after entry as appropriate.
Maintain patient confidentiality as defined by state, federal and company regulations.
CIGNA HEALTHSPRING
Medical Records Admin (July 2012-August 2014)
Maintain tracking of workflow utilizing excel spreadsheet.
Verify if charts are code able and eligible for reimbursement.
Review patient records for timeliness, completeness, accuracy, and appropriateness of health data.
Organize and maintain data for clinical database and registries.
Analyzing data in Excel.
Indexing into AppXtender all scanned medical records.
Maintain and update Master Chart list.
QA all documents being uploaded and index.
Document all issues found and relay to supervisor.
Assist in preparing documents to be utilized at provider location.
Ensure monthly and quarterly reports/presentations communicating Fixed Asset activity are completed as needed.
Assist in scheduling, coordinating, and communicating with providers and internal clients.
MDHA HOUSING
Education Specialist (March 2009- October 2011)
Educate clients on home energy efficiency.
Assisted clients applying for weatherization program.
Update state websites with contractor information.
Assisted Medical records Director with daily functions.
Assist auditor with checking for accurate licensing.
Assisted financial advisors with billing.
TN WOMEN’S CARE
A/R Specialist (March 2007-March 2009)
Billing and collections for government and commercial insurances.
Processed billings to patients and third-party reimbursement claims.
Maintained supporting documentation files and current patient addresses.
Researched and responded to patients’ inquiries regarding billing issues.
Monitored unpaid claims and resubmitted as necessary.
Participated in developing and organizing procedures and updating manuals.
Performed a variety of general clerical duties.
Post and reconcile payments to patient ledgers.
Processed patients’ statements, keyed data, post transactions, and verified accuracy of reports.
EDUCATION
KAPLAN UNIVERSITY, Fort Lauderdale, FL
Master of Informatics, March. 2018
GPA: 4.0
KAPLAN UNIVERSITY, Fort Lauderdale, FL
Master of Public Health, Dec. 2013
GPA: 4.0
TENNESSE STATE UNIVERSITY, Nashville, TN
Bachelor of Science in Health Information Management, 2007
GPA: 3.0
CERTIFICATIONS
Certified CNT
ADDITIONAL INFORMATION
Technical Expertise: Microsoft Office proficient; Familiar with scheduling systems (On shift, shift board, kick serve) Oracle, Med Pac, Star panel, Experian, Alpha Collector, Meditech, AppXtender, Chart Sync, Chart finder, eClinicalWorks, Epic, Rhumba, Key health, Passport, Availity, OneSource, ACS medical bill Processing portal, BWC, CMCS, ICD-9-CM, CPT, HCPCS
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