NATASHA LEWIS

***** ** ****** *** *** *** *****, Temple Terrace, FL · 813-***-****

·adrv1t@r.postjobfree.com

To obtain a job with this developing company were I will use my claim skills, computer and clerical skills to ease the use of your system development.

EXPERIENCE

JULY 2014– CURRENT

REP DATA ENTRY III, quest diagnostics

Accurate data entry of all required information on requisitions

Maintains compliance and HIPAA regulations at all times

Ability to work in a fast-paced environment

Ability to meet quality and production standards

Detail-oriented with independent work habits

Demonstrates an ability to learn the job duties assigned to the DET 1, and develops an understanding of how all the functions in specimen processing fit together

Demonstrates an understanding of the compliance policies related to specimen processing

Ability to work overtime as needed

Ability to visually interpret information

Ability to work independently and as a part of a team

Communicates effectively and is cooperative with all levels of staff

Maintain composure while working under pressure

Excellent attention to details

Demonstrates strong interpersonal skills that foster a positive environment

AUG 2009 – DEC 2010

CLAIMS SPECIALISTS, wellcare

Process claims that are for various hold reasons and assist in the final determination on claim disposition

Process adjustments related to projects or correspondence

Research post payment claims issues and take necessary action for resolution

Research and process all of the following work types: Case Logs, Analyzers, Manuals, Hospital Audits, Appeals, Web Inquiries

Assists with special projects

All other duties

JULY 2007 – AUG 2009

FRONT END SPECIALIST / CONFIGURATION SPECIALIST, wellcare

Transcribe, enter, and validate data from standard search documents

Organize workload to ensure all new work processed on a “first in-first out” basis

Loads professional contracts into the diamond system through appropriate research and provider data load activities

Loads new providers as a results of the approved credentialing committee list.

Coordinate with membership for member move request.

Assist in updating payable procedure codes, price rules and fee schedules

Resolve critical errors forwarded from the claims department

Responsible for building and maintaining positive business relationship with business partners

Meets productivity expectations

JAN 2007 – JUL 2007

COST CONTAINMENT UNIT, wellcare

Posted vendor recoveries

Voided checks and adjusted the claims attached

Data entry manual claims

Responded to claim status correspondence

Operated the internet research using Medicare ID#

Data entry intakes appeals & greavience

EDUCATION

MAR 1993 – JUN 1994

HIGH SCHOOL DIPLOMA, Delaware valley job corp

Clerical Occupation/Clerk Typist Certificate

SKILLS

Basic Computer Knowledge

Great Communication Skills

Adaptable and Flexible

Highly Motivated

Proven ability to Multitask

5yrs CSR skills

4yrs healthcare experience processing claims, between 80-150 claims per day with medical insurance carrier

Efficient with current ICD-9 and CPT procedure codes

Medical terminology

State/federal guidelines and claims resolution.

Excellent typing and organizational skills

Proficient with various word processing applications including Word, Excel, Microsoft, Outlook and claim facts.

CERTIFICATIONS

Certificate of Recognition for Outstanding Quality for 2nd, 3rd & 4th Quarter

Certificate of Recognition for Outstanding Attendance

Certificate of Recognition for shining star

Certificate of completion for HIPPAA Compliance for Health Plans/HCCS Fraud Awareness

Claims Adjudication Training

REFERENCES

Furnish upon request

Contact this candidate