Enrollment specialist and Medical Billing Coding Specialist
Resume:
La Vonne V. Dawson
**** *. **** *** ****# *-*** Denver CO 80238
Cell: 720-***-**** • Email: ***.***********@*****.***
Career objective
Looking for a claims processing, medical billing and coding specialist, Medicaid/ Medicare eligibility position utilizing skills and experience in coding, reconciling insurance and resolving accounts related concerns.
MAJOR QUALIFICATIONS
•Over 5 years of hands on experience working in claims processing with Medicare/ Medicaid eligibility
•Extremely familiar with medical terminology
•Computer-MS office suite, excel, quick books and more
•Billing and coding
SPECIAL SKILLS
•Highly skilled in translating codes into insurance company preferred coding coding systems
•Able to perform change review, claims submission, claim follow up, payment posting and patient statements
•In depth knowledge of preparing appropriate medical codes, and checking eligibility of state portal documents.
•Proficient updating members claims and attestation forms in a timely.
KEY ACCOMPLISHMENTS
•Successfully managed billing services, Medicare/ Medicaid services pertaining to 52 patients or more in a single day without errors
•Obtained honors after on the job training.
PROFESSIONAL EXPERIENCE
Walgreens-Aurora Colorado
Medical billing and coding specialist Dec 2010-Nov 2011
•Code records by following prescribed coding standards such as ICD-9 and CPT
•Review physical notes and obtain necessary classifications when necessary
•Ensure signatures on all medical records
•Update documents with appropriate name, dates for members.
•Prepare appropriate claim documents
•Follow up with insurance companies and ensure that all claims come to fruition.
•6 years experience in administration support, Proficiency in Microsoft.
Brook Dale Senior Living- DTC Colorado
Resident service Nov 2011-Jun 2012
•Performed day to day functions as a resident assistant with Seniors. Administrating medication, grooming and activities.
•Review patient medical and medication records for proper documentation.
•Did every two hour checks to make sure resident was save at all times.
•Reported any falls, illnesses, and strange bruises on residents body.
STAY at home mom- Nov 2012- Oct 2015
PETSMART Oct 2015- Dec 2016
Unloading and restocking store shelves before store opens.
Target Dec 2016-Aug 2017
Unloading and restocking shelves before store opens.
Anthem BCBS/ Elevance health. Aug 2017-present
Started as a temp Enrolling members for AEP enrollment, updating enrollment applications.
Resubmission- Medicare/Medicaid eligibility through state portals, using Medisys WellPoint/ dashboard systems, Esrd and hospice verification and any updates. I worked in the reconciliation department helping with out of area know as (OOA) verifying out of area addresses based on members state.
EDUCATION
Concorde career college of Aurora-Aurora Colorado
Medical coding specialist -Feb 2010-Dec 2010
ADDITIONAL CAPABILITIES
•Excellent written and verbal communication skills
•Highly motivated personality with positive approach
•Proven ability to speak in confident and assertive manner
•Exceptional telephone etiquette
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