Cassandra L. Reid

317-***-****

ad2wuo@r.postjobfree.com

SKILLS AND QUALIFICATIONS

*Extensive number of years of experience and competent as a versatile processor of Medical, Dental, Workman’s Comp Claims & Customer Service Rep as well as Data Entry, Account Receivable and Payable Processor, Credentialing and Collections.

*Thorough knowledge of Medical and Dental codes, Medicaid, Medicare, CMS, HCPCS and ICD9 codes, COBRA, Cob’s, various types of claims, HMO, PPO, POS, DME’s and the progression of a claim from beginning to end.

*Experienced with fee schedules, claim forms UB94/04 and 1500.

*Proficient with Windows Environment, Excel, Lotus Notes, PowerPoint, Microsoft Word, Outlook, Citrix Meta frame, TPX, AFS, DEALS, JDE, SharePoint, Microsoft Access and Loan Momentum.

*Usage of medical programs including AS400, SAR, System 80, Claim Pro, Facets, Nasco, FEP,WebMD (EMDEON), Web Denis, Champs and various databases and office equipment.

*Excellent communication skills and SAP Data Entry and People Soft.

*Quality and accuracy driven. Knowledgeable in the field of subrogation of a claim.

*Proficient in accounts payable/receivable, ERP system, chargebacks, 3-way matching, escrow processing, cod’s, po’s, bank reconciliations, journal entries and general ledger, billing statements and payment processing, monthly, quarterly, yearly end closings and reports.

WORK EXPERIENCE

9/22-1/23 Loan Operations Specialist

Randstad/Flagstar Bank-Troy, MI 48084

*Book/manage commercial loan to the accounting system of Loan Momentum.

*Input accurate/timely documentation and able to question docs outside of the norm.

*Book Letters of Credit, post transactions, paydowns, payoffs, adjustments, advances to the accounting system (LM) and system of record (AFS).

*Correct errors from the daily report. Input live checks into system and applied accordingly in LM. Input check into into LM for overpayment.

*Utilize and update spreadsheets for different types of loans.

*Balance the General Ledger and balance at the end of the day.

12/21-7/22 General Ledger Admin

Binding Minds Inc/Comerica,- Hillsborough, NJ 08844

*General Ledger Research finding Billions and balancing the monies using various reconcilement reports, vendor systems and reporting.

*General Ledger Entry Posting using PC Link upload via Excel. Posting entries.

*Assist with resolving aged out of balances including escalating uncleared monies and differences to another area for clarity.

*Document results on a master aging report via excel spreadsheet and troubleshoot issues.

*Communicate and identify concerns about aged monies.

9/21-9/21 Customer Service/Scanner

Harvard Resource Solutions, Troy, MI 48084

*Greeted customers and clients.

*Directed clients to the correct conference room.

*Scanned badges for entry into the conference room.

1/17-11/19 Provider Relations Specialist

FDI Group/Manageability Inc-Novi, MI

*Answered incoming calls from providers and or adjusters about pip and workman’s comp claims and the denial process. Provided back-up duties for the receptionist.

*Document claim results from a call into its proper system.

*Looked up claim information for providers and advised how to properly send in documentation for the claim to be considered for reconsideration.

*Identified inaccuracies of a claim for overpayments and resolved for resolution.

*Contacted and emailed adjusters about difficult providers concerning their claim for resolution.

*Monitored the voicemail as it pertains to providers calling about the pip and workman’s comp claims. Made necessary callbacks if needed.

*Onboarded providers information, credentials and tax id into a new system, Mitchell as well as claims information.

*EDI Edits/Clearinghouse, entered data for Providers and adjusters, check information as well as checked payment info for checks.

4/15-8/16 Risk Management Specialist

BrassCraft Manufacturing/Manpower-Taylor, MI

*Field incoming calls. Provided back-up for the receptionist.

*Open and process all incoming mail.

*Open and process all incoming/outgoing evidence.

*Processed new plumber claims, entering them into JDE database and windows environment.

*Created and maintained a physical claim file. Input and processed Cobra claims into JDE.

*Followed-up and investigated on claim diaries.

*Interfaced with insurance companies, claimants, contractors and Masco personnel as required.

*Assisted in preparing confidential legal documents, reports and correspondence.

*Performed audit functions on claim files.

*Completed special projects as assigned.

*Provided administrative support to the department.

12/14-12/14 Accounts Receivable and B2B Collections Rep.

Bureau Veritas /Accounting Principals-Troy, MI

*Made Follow up calls to businesses to collect, unpaid accounts and resolve any discrepancies.

*Took credit card information for payments over the phone to input into the windows environment system.

*Worked on year end reports to resolve all monies past due and collect what was owed on the accounts.

*Sent out notices to account holders for outstanding past due accounts.

6/13-6/14 Vendor Invoice Management Specialist

Philips Healthcare/CSA, LLC-Lees Summit, MO

*Checked order acknowledgements from vendors for correct coding information via SAP and windows environment.

*Processed, reviewed and managed invoices in workflow daily.

*Contacted vendors for correct information via email and phone. Input and processed purchase orders into the Vendor Invoice Log.

*Logged incorrect amounts on a discrepancy report. Collected monies owed if warranted.

*Obtained approval from IPM's for invoices and checked invoices for any discrepancies.

*Responsible for correcting and verifying accounts payable amounts and info in SAP for check approval process. Processed and reviewed daily invoices in SAP, 3-way matching.

*Reviewed reports for 12 regions and their contents for discrepancies and corrected for input into the system. Followed up on all discrepancies for resolution.

7/12-1/13 Managed Care Analyst,

Detroit Medical Center (DMC)/Bottom Line Systems (BLS), Inc-Crescent Springs, KY

*Primarily responsible for identifying underpayments and overpayments for an assigned client and or provider in facets.

*Reviewed managed care contracts against health care claims for possible underpayments/overpayments and reviewed medical records.

*Contacted insurance companies, providers for missing information such as, eobs, adjustments, status of a claim, and arrange & collect payments that were due. Performed accounts receivable from payers.

*Post payments, provider data and notes in the AS400 system.

*Calculated reimbursement based on the language and contract terms.

8/11-6/12 Data Entry Processor

Pilz Automation/Accounting Principals-Troy, MI

*Enter and process machine data information onto excel spread sheet via program called International Service Tool Program. Enter accounts receivable into SAP database and Windows Environment.

*Enter customers information on excel spread sheet.

*Confirm data and customers information with technicians via email and telephone.

7/09-12/10 Commercial Loan Processor

Comerica/Kelly Services-Troy, MI

*Processed general ledgers, journal entries, ACH payments, processed escrow payments and checks and invoices into the Windows Environment system.

*Corrected bank reconciliations issues.

*Reconcile month end and quarterly reports, balance individual and group blotters using excel spreadsheets, contact and resolve loan payments issues with bank officers and lending assistants via email and telephone, cut and distribute checks to customers.

*Contacted customers for status of payments and for issues. Received, collected monies and processed checks from customers, processed payments via wires and lock box.

*Clearing reports of under/over payments.

*Reverse payments due to errors, overpayments and adjustments. Credit DDA accounts. Experienced in month, quarter, and year end closings.

*Processed accounts payable and receivables, processed cash receipts and invoices & filing.

5/09-6/09- Appraisal Analyst

TSI Appraisal/Kelly Services-Livonia, MI

*Contact appraisers for status on appraisals via email and telephone. Log notes into Windows Environment and CMI systems.

*Contact loan borrowers for input on appraisers. Adjust fees for appraisers.

*Contact Loan officers for problems that arise with borrowers. Scheduled appraisers for appraisals appointments. Update excels reports on all unsolved issues, contact underwriters about issues that arise. Upload appraisal reports and policy forms into the system.

1/08-4/08 Mortgage Refinance Rep/CSR

CitiMortgage/Adecco-Bingham Farms, MI

*Processed & Data entered refinance application & into a Windows Environment computer system for approval. Processed escrow payments.

*Processed & Data entered modifications on loans for rates and calculate payment.

*Quote interest rates and payments using amortization calculator, imaged & copied documents.

*Make & take welcome calls to existing refinance customers in a call center environment.

*Fill out worksheets for withdrawals and spreadsheets, knowledgeable in LPM and Citi works.

*Collect monies & processed credit card payments and accounts receivable into computer system.

*Update weekly status on borrower’s information and updated daily excel reports.

*5/01-8/07 Claims Rep-Teleworker

Anthem BC/BS-Indianapolis, IN

*Review, investigate, evaluate and process claims & intakes for correct resolution within guidelines & verified insurance.

*Processed EDI member/provider claims into facets.

*I worked on aged reports 30dys or older, utilized claims inquiry. Initiated provider/member research and retrieved claims from workflow.

*Researched member’s eligibility for referrals and authorization.

*Researched enrollment status and covered benefits for covered services. Reviewed medical necessity for appropriate care.

*Process/adjust complex health & dental & workman’s comp claims, responded to inquiries, prepared claims for accounts payable reimbursements.

*Updated and loaded all provider info into a database for membership eligibility and enrollment. Distributed billing statements.

*Apply medical guidelines for approval or denial and review medical records and notes.

*Reconciled accounts receivables and prepared resubmissions and re-bills.

*Reconciled accounts payables and prepared chargebacks and charge entry.

* Processed recovery for overpayments. Initiated calls to members for collections.

*Preview claims for utilization review & sent claims to nurses for review, prepare expense reports.

*Review medical records for determination of pre-existing conditions.

*Reopen, adjust and void claims on-line within guidelines and contacted patients for collection of monies, received and processed payments into computer system, SAP data entry and People Soft.

EDUCATION

Oakland University, Rochester MI

Computer Science & Math-Undergraduate

IUPUI, Indianapolis, IN

Psychology-Undergraduate

SALARY REQUIREMENTS

Minimum of $30/hr.

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