Medical Entry Operator

KIRANMAI J. DOODI

***** ******* ***** ***: 301-***-****

Germantown

MD 20876-2703 ********@*******.***

SKILLS:

Strong Knowledge and experience in Healthcare Demographics, Medical Terminology, EOBs, Clinic/Hospital Claims, Insurance Eligibility Verification.

Experienced in using EPIC health care software for Hospitals EHR (Electronic Health Records).

Extensively used variety of Insurance verification software including Emdeon, Insta Med, CMS (Federal Medicare) and Info crossing (Federal Medicare).

Strong Knowledge and Expert in handling Healthcare Demographics (including Clinic and Hospital Charges) and Insurance Payments.

Knowledge and experience in Healthcare Software: EMR, EHR & ECW.

Ability to handle sensitive information and maintained security and confidentiality of medical records and Protected Health Information (PHI).

Knowledge & familiarity with CPT Codes & ICD- 9 & ICD-10 Codes.

Experienced in using Claims platforms: UNET, CSP FACETS AND DOC360 CLAIMS.

Expertise & skills in Microsoft Word, Excel and Word Processor and Outlook. And ability to type 50 wpm.

Experienced in using variety of Healthcare Software/Provider Portals like Misys, Lytec, RealMed & Prime SUITE (Greenway).

Proficient in pulling Claims & EOBs (including Primary & Secondary) from different Software.

Communicates with Insurance carriers, Hospitals, Providers, Members, Vendors, Co-workers and all team members in a courteous and professional manner.

Proficient in verification of data and detecting errors and correcting document codes.

Achieves and maintains 100% quality in work.

Expert in review data, Indexing, Document prepping, Scanning, Document imaging.

Flexible, Dedicated, Hard worker, Detail oriented and good team player.

EXPERIENCE:

3 months of experience as a Medical Record Abstractor.

4 years of experience as a Sr. Recovery / Resolutions Representative (Co-ordination of Benefits Representative).

2 years of experience as a Medical Records Clerk/Data Entry Lead/Claims Assistant.

4 years of experience as a Senior Data Entry Operator/ Indexing/Document Prep.

EDUCATION:

Masters in Geography, 1995

Diploma in Computer Science, 1996

MS Office 2007 Certification, 2011

TECHNICAL SKILLS:

Software: Microsoft Windows, MS Word, Excel, Word Processor, Outlook.

STATUS: US Citizen.

PROFESSIONAL EXPERIENCE

1.WESTAT Oct 2020 to Dec 2020

Medical Record Abstractor

Westat is an employee-owned professional services corporation. It provides research services to agencies of the U.S. Government, as well as businesses, foundations, and state and local governments.

As a Medical Record Abstractor, I perform:

Review Hospital emergency medical records and other source documents including Provider notes, Nursing notes, Triage notes, clinical assessment notes and collect required data according to specifications and guidelines provided by DAWN (Drug Abuse Warning Network) project at WESTAT for SAMHSA (Substance Abuse and Mental Health Services Administration). Data collected may include demographics, disease-specific data elements, diagnosis/clinical impression, medications, alcohol abuse and substance abuse. Abstract the data from assigned Hospital using EPIC healthcare software and enter the abstracted data into DAWN (Drug Abuse Warning Network) CRS (Case Reporting System) software according to the specific guidelines.

References:

JudithMvula Mwenda (Manager)

Contact / Mobile #703-***-****/240-***-****

Email: ***********-******@******.***

Anuradha Jatavallabhula (Medical Record Abstractor)/(Co-worker)

Contact / Mobile #845-***-****

Email: **********************@******.***

2. OPTUM/United Healthcare Oct 2016 to Sept 2020

Sr. Recovery/Resolutions Representative

(Coordination of Benefits Representative)

As an Optum Coordination of Benefits Representative, I perform investigative work to validate insurance coverage with other carriers for United Healthcare (UHC) members that have multiple health insurance coverages to ensure claims are processed correctly by the payer with primary payment responsibility.

Primary Responsibilities:

Make outbound calls to providers/Insurance carriers to discuss and obtain Insurance effective and term dates and other benefits

Reconfirm/add the information into different systems as per state SOPs and workflow guidelines

Escalate recovery efforts through many avenues to progress and resolve the situations

Strive to meet and exceed quality production defined goals (calls / contacts), including a financial target

Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance

References:

Holly Rutledge (Former Manager)

Contact / Mobile #301-***-****

Sonal Chalke (Sr. COB Resolution and Appeals Team Representative)

Contact/Mobile #908-***-****

Email: ******.*****@*****.***

3. THE BUSINESSSIDE INC April 2014 to July 2016

Medical Records Clerk / Data Entry Lead/ Claims Assistant

The BusinessSide provides a full range of billing and financial support services to

Medical institutions and physicians in Washington DC, Maryland, Virginia and Pennsylvania.

The BusinessSide offers a wide range of solutions, including demographic and charge entry, payment posting, accounts receivable management, collections, financial reporting, and other support services for medical institutions and network.

Performed following tasks:

Handling all Clinic & Hospital Charges and Different payments

Scanning all Medical Records, Data Entry, Filing and report to Manager

Responding to inquiries and take clear concise messages

Pulling Claims & EOBs, Medical records & referral forms for appeals

Handling all documents related to payments, referrals, claims, etc.

References:

Lisa Dashnaw (Billing Representative)

Contact # 301-***-**** Ext: 1037

Mobile #240-***-****

Grace Ortiz (Billing Specialist)

Contact # 301-***-**** Ext: 1047

4. QUALITY FIRST IMAGING, INC. AUGUST 2009 – APRIL 2010

Data Entry Operator

Quality First Imaging, Inc. (QFI), a wholly owned subsidiary of United Strategies Inc., provides following services in document imaging and mass data storage for its clients.

As a data entry operator, I performed following tasks:

Document Preparation, Imaging Processing, Indexing Basics,

Index each document or document set based on information in the source documents or based on the content of the barcode

Validate index data against the customer provided database

Reviewed documents for accuracy and Corrected errors and return documents to source or enter missing data

References:

Mr. Allen (Manager)

Contact# 301-***-**** / 301-***-****

Mrs. Kanchan Gautham (Data Entry Operator)

Contact# 301-***-****

5. DIRECTECH, INC. MAY 2000 - AUGUST 2003

Data Entry Operator

Worked as a Data Entry Specialist at DirecTech, Inc. for about 3 and half years.

This company was responsible for daily production data capture activities. Data Capture operations and Donation Processing simultaneously for many various non – profit organizations and political lobbyist clients such as: American Red Cross Cancer Research Foundation, Air Force Memorial Foundation.

As a data entry operator I performed following tasks:

Entering customer data, processing customer account based on customer source documents. Maintaining data entry requirements, securing information.

Entered details of checks and verified them at a speed of 1000 checks per hour. Balancing and generation reports for various clients.

References:

Miss. Diane Peters (Asst. Supervisor)

Contact# 301-***-****

Email: **********@*******.***

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