Zakiya Ray

ad4l79@r.postjobfree.com

OBJECTIVE

I’m a seasoned Medical Customer Service Specialist, with several years of in-depth benefits/claims experience. I’m goal orientated, a team player, I’m always motivated to learn new things and to use my experience in different areas.

PROFESSIONAL SKILLS SUMMARY

•Collections

•Interpersonal and Analytical Skills

•ACA Government Program

•Claims Review

•Insurance Verification

•Guiding Care

•Hospital clinical setting

•Medical Terminology

•Scheduling

•Knowledge of Medicare/Medicaid

•Benefits

•Reimbursement Specialist

•Revenue Cycle Management

•Posting & adjusting payments

EMPLOYMENT EXPERIENCE

Care Guide Benefits Advocate, Call Center 11/2019-Present

Spira Care- Blue Cross Blue Shields, Kansas City, Missouri

Assisted Providers and Members in claims, eligibility, benefit coverage, authorization status with access to Guiding Care

Assisted with benefits for Members on the Government Program (ACA)

Researched provider and hospitals for in and out of network participation

Assisted Members and Providers with Scheduling

Transmit Claims for further investigation

Liaison with different department and Nursing staff

Reimbursement Specialist 10/2018-05/19

Aerotek-Trial Card, Kansas City, Missouri

Enter claims into database systems

Transmit claims for payment or further investigations

Contacted Insurance Companies about Benefits and Eligibility verified

Posting & adjusting payments

Written /Verbal communication

Behavior Health Referral Specialist Coordinator 09/2016 – 10/2018

Triwest Health Care Alliance, Kansas City, Missouri

Review and enters complex authorizations referrals to the VA

Modify authorizations as needed to ensure transfer into claim payment system

Initiates authorizations for outpatient services

Patient Service Representative 11/2015 – 09/2016

Aerotek-Triwest Health Alliance, Kansas City, Missouri

Receives and prepares authorizations for appointing

Responds to inquiries from Veterans and Providers

Keep records of customer interactions or transactions, recording details of inquiries, complaints

Patient Service Representative 10/2012 – 08/2015

Sunflower State Health Plan, Lenexa, KS

Assist members with health plan benefits

Knowledge of Medicare/Medicaid health care plans

Assisted Providers in claims, eligibility, benefit coverage and authorization status

EDUCATION

High Tech Institute

Kansas City, Missouri

Certificate\Medical Billing and Coding

State of Missouri

Diploma/High School

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