Customer Service Billing Specialist
Resume:
Karen Harrison
ad1m0n@r.postjobfree.com
Objective
To seek a position in a progressive company where quality customer service, effective communication, and inclusion are key factors.
Encompass Health - Billing Specialist (2016-Present)
To ensure all HIIPA guidelines are followed and report all incidents to maintain account security. Assist customers with their billing and medical needs for timely resolution. Collaborate with various facilities, local and national insurance companies to ensure customer satisfaction.
Experience
7 years of medical billing, coding and claims processing.
Knowledge of Medicare, Medicaid, HMO, PPO, and other
Insurance company legalities, requirements and systems.
Various Billing Systems and Portals (Oracle, Sharepoint, Relay, Patcom, Caremedic ect.)
Familiarity with CPT and ICD-10 coding.
CPR trained.
Microsoft Office Products.
Essential Functions
Validated claim coding to ensure all guidelines are met.
Communicated with various local and national insurance companies to ensure customer’s claim were completed accurately and timely.
Worked with multiple web portals and applications to research unpaid or nonresponsive claims for resolution.
Provided written and oral communication for appeals, record validation for insurance companies.
Audit claims/accounts for charges, duplications, and overlapped accounts prior to billing, making any necessary adjustments.
Knowledge of insurance guidelines including Medicare, Medicaid, HMO, PPO, and other payer requirements and systems.
Various Billing Systems and Portals (Oracle, Relay, Assurance, Patcom, Caremedic,
Ability to perform all other duties assigned or requested.
JPMorgan Chase Treasury Services, Tampa FL
Production Control / Special Services (2013 -2016)
Oversee performance metrics for financial incentive for three lines of business
(ACH Disbursement Operations, Implementation Support.)
Maintained department compliance to ensure no data breaches.
Created and performed daily, monthly, department audits and billing reports.
Resolve all customer billing inquiries and statements.
Responsible for maintaining department procedures..
Acts as a BSA, AML and OFAC subject matter expert to identify process improvements, respond to inquiries from internal business partners.
Oversaw the department’s compliance and training needs.
Utilizes financial product, system, and process knowledge in all lines of business to detect and analyze red flags for money laundering and terrorist finance activity.
ACH Special Services (2011-2013)
Managed the Business Activity Monitoring project for ACH, development, design, documentation and implementation for User, Manager and Executive level dashboards.
Manage the GTI Telecom migration project for the ACH line of business.
Resolved all escalated issues.
Scheduled project meetings and user test reviews.
Ensured all requirement documentation and procedures were updated.
ACH Implementation Project Manager (2009-2011)
Developed new and/or revised Implementation processes and procedures for ACH products and services.
Analyze impact of the new or modified ACH product or service as it relates to client implementations.
End to end ownership of the onboarding of new clients and products.
Develop applicable client implementation test documentation.
Identify any applicable changes needed to the Customer Information Database and work with the IT team in developing requirements.
ACH Transmission Manager (2002-2009)
Lead a team of 16 Transmission Desk Analysts in Bangalore, India/Tampa, FL that oversaw an average of 6500 inbound/outbound file transmissions and 130 calls per day averaging over 100 million dollars while maintaining our departmental goals.
Reviewed and completed department monthly audits.
Ensured departmental team compliance objectives were met according to standards.
Developed process improvements through system automation and workflows.
Manage staffing schedules to guarantee department coverage.
Conducted performance reviews and training.
Systems Quality Assurance Analyst (2001-2002)
Tested and evaluated product systems to meet department quality standards.
Performed quality reviews, fixes and system enhancements.
Ensured all end to end test documentation was completed.
Education
AA degree Pensacola State College
Medical Health Unit Coordinator / Billing Specialist
Completed coursework in introduction to health occupations, medical language, CPR, AIDs and infectious diseases.
Skills
Microsoft Office and numerous proprietary banking computer systems.
Knowledge of Regulation E and Z
Numerous Medical Systems and Portals such as Oracle, Relay, Assurance, Caremedic, Patcom, Sharepoint ect.
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