Prior Authorizations, Administrative Assistant, Data Entry
Resume:
Natania Ware
Atlanta, GA *****
adique@r.postjobfree.com
TECHNICAL SKILLS
Boomerang, Microsoft Excel, NEA Desktop, MIPACS XDR System, Dental Exchange, DentPro Software, Microsoft Office Programs, Customer Focus, Instill Trust, Drive Results WORK EXPERIENCE
United States Postal Service:
Mail Handler Assistant/Mail Handler Equipment Operator May 2020-Present
• Loads/Unloads mail from trucks
• Moves bulk mail and perform other duties to the movement processing of mail
• Separates all mail received from trucks and conveyors for dispatch to other conveying units
• Place empty sacks or pouches on racks, label them where prearranged or where racks are plainly marked, dumps mail from sacks, cut ties, faces letter mail, carries mail to distributors for processing, places processed mail into sacks, removes filled sacks and pouches from racks and closes and locks sacks and pouches. Pick up sacks, pouches, and outside pieces, separates outgoing bulk mails for dispatch and loads mail onto trucks
• Handles and sacks empty equipment; inspects empty equipment for mail and restrings sacks
• Operates a fork-lift or pallet jack truck, as a qualified licensed driver in the performance of transporting mail within a postal facility
• Moves empty equipment utilized in transporting mail to storage of staging area
• Performs routine safety inspection of vehicular equipment utilized; reports deficiencies
• Observes established safety practices and requirements
• Performs other mail handler duties when not occupied as a licensed driver Benevis:
Medicaid Insurance Poster
April 2020-May 2020
• Apply Medicaid Insurance payments and denials to unpaid patient accounts
• Report payer scheduled payment discrepancies
• Report payer payment and denial trends
• Responsible for answering specific inquires from Regional Billing Specialists
• Responsible for ensuring that all reports are completed timely
• Knowledge of Medicaid payer plans
• Familiarity on how to interpret RAs and EOBs
• Knowledge of Dental billing procedure codes
• Strong interpersonal and communication skills
• Ability to work independently and with others in a fast paced environment
• Strong organizational skills with the ability to multi-task
• Flexible with schedule to meet department deadlines
• Detail oriented
Benevis:
December 2018 –March 2020
Orthodontic Pre-Authorization/Follow up Specialist
• Pull authorization requests from PA/OCR queue
• Collect all the necessary information to prepare insurance claims
• Submit prior authorizations to payer
• Check status of authorizations and effectively communicate the status to the Ortho Revenue Cycle Specialist and Ortho field teams for their claims as well as documenting the status in Boomerang
• Responsible for researching, correcting and resubmitting rejected and denied claims
• Research, resolved, and track pre-authorization denials
• Contact payers to follow up on authorizations and denials
• Update the PA/OCR queue on prior authorizations status
• Maintain patient confidentially as defined by state, federal and company regulations Benevis:
March 2017 – Dec 2018
Authorization Specialist
• Pulled authorization requests from PA/OCR queue
• Submissions of prior and post authorizations
• Submission of post authorizations
• Contacted payer to follow up on authorizations by checking status
• Updated of queue on prior and authorization status
• Detailed view of treatment planned and procedures performed to ensure that they are within the payer guidelines and met the company compliance standards
• Generation of approved authorization claims to payers
• Generated a weekly report for Internal Clinical Review
• Reported and documented the status of approvals in Boomerang and communicates with clinics accordingly
Benevis:
May 2010 – March 2017
AR Mail Clerk
• Retrieved daily mail via receptionist or mailbox
• Sorted, scanned, and batched mail, for AR Clerk within 24 hours of receipt
• Interpret and process Explanation of Benefit for clients
• Entered all commercial EOB’s and Medicaid RA’s into the database within 48 hours of receipt
• Entered all EOB’s via Dental X-change and payer website within 24 hours of EFT notification
• Contacted payer and request and research any missing EOB pages prior to batch completion
• Maintained storage system for all Commercial EOB’s and Medicaid RA’s that are pending posting completion
Education:
Atlanta Technical College
June 2005-June 2008
Culinary Arts
Diploma
Frederick Douglass High School
August 1999-May 2005
High School Diploma
Contact this candidate