* ******** ****

Liverpool, NY *****

315-***-****

Shawna Fleming

March 2020 – July 2021 Wellnow Urgent Care East Syracuse, NY

Billing Specialist

Answered incoming calls from patients, insurance companies and other facilities

Ran and worked on accounts receivable reports, which included the write off of small balances

Answered the companies emails and responded to voicemails in a timely manner

Assisted the claims department to help improve the accuracy and timeliness of claim completions

Feb 2019 – Aug 2019 Padcare Inc. East Syracuse, NY

Customer Service Specialist

Phone customer service to locate lost pets

Phone sales of pet tags

Sept 2013 – Feb 2014 Excellus Blue Cross Blue Shield Dewitt, NY

Membership and Billing Specialist (Temporary Position)

Add insurance applications to I-FACETS system

Perform various customer service duties

Expected to maintain a 95% accuracy rate

Investigate applications to ensure correct plan placement

Answer broker and client emails inquiries

Retrieve applications through the SIR System for review and post to I-FACETS system

Review COB and COBRA applications

Review court documentation to add child dependents to policies

Scan applications to be added to computer systems

March 2012 – June 2013 HOACNY East Syracuse, NY

Billing Specialist

Performed customer service tasks including patient phone calls, insurance company phone calls

Duties included billing/posting of payments, mail denials, AR reports, patient and insurance refunds, sending/reviewing of statements

Strong knowledge of several types of insurances including Medicaid, Medicare, BCBS, Aetna, POMCO, UHC, Rmsco as well as many others.

Worked in MOSAIQ and Next-Gene systems

2000 – 2012 POMCO Syracuse, NY

Medical Claims Processor

Process medical claims according to plan parameters set forth by client

Utilize knowledge of CPT, icd9, HCPS, and medical terminology

Understanding of Medicare and other carrier explanation of benefits for claim adjudication used daily

Responsible for providing customer rep duties as needed

Maintain quotas and accuracy of processed claims

Team Leader to four other claims associates

Primary processor for 3 clients

Log customer calls into computer system

Verify enrollment and quoted medical benefits

Maintain accuracy and payment percentages

1997 – 2000 SSAC Baldwinsville, NY

Electronics Assembler

Responsible for assembling electronic circuit boards

1996 Graduate of J.C. Bridlebough High School Phoenix, NY

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