Ida Ferguson

**** ***** ****

College Park GA ***49

ad3jyk@r.postjobfree.com

347-***-****

Work Experience

Claims Examiner II

Lincoln Financial Group - Atlanta,

GA June 2022-Present

• Delivers routine work independently, in accordance with established procedures and guidelines, in a timely manner and meets deadlines appropriately. • Ensures the accuracy and completeness of submitted claims. • Processes increasingly complex assigned claims for payment or denial in accordance with established procedures and guidelines, in a timely manner and meeting departmental quality/production standards. • Carries out duties in compliance with all state and federal regulations and guidelines. Complies with all company and site policies and procedures. Dental VOB, Claims and Disability

Lincoln Financial Group - Atlanta, GA

April 2021 to June 2022

• Assist providers and policy holders with dental benefit information. • Provide update status/Payment on claims that have been submitted by provider. • Submit claims for reconsideration is denial is incorrect on LFG behalf. Submit escalations to supervisors for call backs to providers/policy holder

Service Validation Representative/Remote

CareCentrix - Hartford, CT

April 2019 to March 2021

• Worked from Home remotely, making sure patients received their DME supplies in a timely manner. • Researched and resolved cases that were escalated for further review due to patient not receiving supplies.• Reached out to Health Plans, Physicians and Providers to ensure patient documents are in place to receive supplies. Network Service Advocate

CareCentrix - Hartford, CT

August 2017 to April 2019

Provide claim status support to providers calling in for claim status. ● Create resolutions to advanced research team for clarification on claim denial, rejection, or payment issues. ● Research and respond to cases submitted for advance research Utilization Management Assistant

J. Morrissey Temp Agency for ConnectiCare Total Population Health - Farmington, CT June 2017 to August 2017

Initiates completion of approved member and provider correspondence, where appropriate and according to departmental guidelines.● Responds to inquiries from providers, members and Connecticuter (CCI) employees. Recognizes when it’s appropriate to triage inquiry to TPH clinician for additional review or intervention. ● Communicates with members and providers regarding member's authorization status, as required. Customer Service Associate

Integerity Staffing at Aetna EAP Behavioral Health - Hartford, CT October 2016 to February 2017

Provided telephone triage, crisis intervention and related services● Assessed of members immediate needs.● Utilized appropriate tools to identify and provide services.● Engaged and provide members immediate support and assist with coping skills Referral Coordinator

Physician's Ancillary Services - Rocky Hill, CT April 2015 to September 2016 Insurance verification, submit and follow up with prior authorizations accordingly. ● Processed of referrals for EEG study, scheduling, confirming EEG set ups. ● Corresponded with all referring physicians for additional patient information. Medical Records Advanced Medical Solutions Agency/Consulting Cardiologist - Hartford, CT July 2012 to April 2015

CT Medical Records ● Scanned and indexed confidential medical records. ● Processed medical record requests, via fax or phone

● Collected payment for medical records request.

Clerical Support

Whedco - Bronx, NY

May 2010 to July 2012

Assisted Database Administrator with mailing of termination notices to providers and parents. ● Completed scanning and indexing of all enrollment applications received from off-site locations. ● Worked with HRA/ACS in the preparation of childcare enrollment applications.

Per Diem/Medical Assistant/Receptionist

Winston Staffing - New York, NY

November 2007 to May 2010

Assigned to vary healthcare facilities by staffing agency. ● Provided patient care such as vital signs, venipuncture and collection of specimens. ● Filed charts, preparing charts for new patients, making/rescheduling patients’ appointments. SSI Disability Unit-Project Assistant

F.E.G.S. WeCare - Bronx, NY

July 2005 to November 2007

Created and presented spreadsheets as needed to support management team. ● Successfully handled clerical duties in preparation for audits, or inspections of the program. ● Assisted in the set-up process for new staff and updated relevant lists to reflect all changes.

Nursing Care Technician/Float Pool

Beth Israel Medical Center - New York, NY

June 1998 to September 2003

Worked in various clinics within the facility, Pediatrics, Gastroenterology, OB/GYN and more. ● Assisted physicians during minor surgeries, MOH's, varied skin cancer removals and biopsies. ● Assisted physicians with colposcopy, patient annual GYN exam, and more.

Education

Associate in Healthcare Administration

Keiser University - Fort Lauderdale, FL

March 2014 to May 2016

Medical Assistant

SUNY Bronx Educational Opportunity Center - Bronx, NY July 1997 to June 1998

Reference Upon Request

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