Data Entry Claims Processor

CHERYL D. HARPER

**** ******* **** *******, ** 38118 901-***-**** ****************@*****.***

FINANCIAL SERVICES SPECIALIST

Payment Services

Commercial ~ Medicare ~ TennCare

Solutions oriented Insurance professional with experience working with both

3rd party billing companies and Insurance providers. An interested and fast learner who shares knowledge with team to improve results for all. Independent worker with keen ability to analyze and solve issues quickly and accurately.

Key Skills Include:

Reimbursement Analysis

Commercial, Medicare, TennCare

Knowledge

Analytical Thinking

ICD-9,CPT codes and Medical Terminology

Interpersonal Skills

Claim Resolution

PROFESSIONAL EXPERIENCE

CaducesHealth

09/2020 Present

Financial Services Specialist

Analyze unpostables to determine where payments should be posted.

Analyze and accurately match bank deposits to billing systems deposits and upload remittances into the Athena system to be posted.

Worked the unpostable dashboard daily in Athena.

Checked several carriers to pull remits for payments and denials.

Payment Variance Analyst

Analyze claims data to assure appropriate reimbursement

Train analysts and consult as onsite expert for issue escalation

Liaison for provider reps regarding shortages, etc.

Partners Central Business Office 10/2014 – 08/2020

Senior Analyst – Payment Variance 01/2016 – Present

Payment Variance Analyst 12/2014 – 01/2016

Reimbursement Analyst 10/2014 – 12/2014

Analyze claims data to assure appropriate reimbursement

Train analysts and consult as onsite expert for issue escalation

Liaison for provider reps regarding shortages, etc.

U T Medical Group Inc 2009 – 2014

Reimbursement Analyst, Revenue Services

12/2010 – 10/2014

Performance Improvement Specialist, Revenue Services

11/2009 – 12/2010

Provided support to Commercial, Medicare, and TennCare providers

Analyze claims data to insure appropriate reimbursement

Identify errors in contract management system and recommend solutions

Amerigroup Corporation (formerly Memphis Managed Care) 2001 – 2009

Team Leader, Claims Department 2003 - 2009

Claims Adjudicator 2001 – 2003

Provide support to providers and peers to resolve claim issues

Customer focus system- research and resolve complex claims

CHERYL D. HARPER 901-***-**** Page 2 0f 2

Amerigroup Professional Experience Continued

Claim processing for medical and dental claims

Coordinate benefits for enrollees with other insurances

Recipient of numerous STAR awards for outstanding performance

Blue Cross Blue Shield 1987- 2001

Team Leader 1998 - 2001

Claims Adjuster 1994 - 1998

Senior Claims Processor/EEC Clerk 1989 - 1994

Pre Computer Clerk 1987 – 1989

Research and resolve complex claims

Award winning productivity

Training assistance

Utilize Nasco claims system for claim information

Analyze and audit appeals to assure correct processing

TECHNOLOGY

Microsoft Word

Excel

10 Key by touch

Data Entry

Contact this candidate