SHANTEL T. TAYLOR

213-***-****

PROFESSIONAL EXPERIENCE

Cedars Sinai Medical Center

Health Information Technician 1- September 2021- Present

Performs health information activities necessary to coordinate, maintain and use electronic and paper patient health records. Depending on assignments, specialize in one or more clerical functions, such as coding clerical support, transcription processing. Coordination of record request, image scanning quality auditing, or serve as the satellite rep in off-campus locations.

• Analyze/research errors. Participate in quality reviews.

• Compile and trend data and generate reports.

• Queries multiple electronic records and tracking systems.

• Understands chart organization and content, CSMC and external requirements related to chart documentation and privacy.

• Performs as a backup for prepping and scanning records as needed, to meet department goals.

BHS Behavioral Health Services

Registration Receptionist May 2021- September 2021

Scheduling various appointments requested

Transferring calls appropriately

Composing messages for providers & patient’s prescriptions when necessary

Providing general information to providers & patients

Working in various vaccine clinics

Heavy data entry daily

USC Care

Charge Entry Clerk - January 2020- March 2020

Responsible for reviewing patient’s billing & insurance

Responsible for submitting claims to the correct insurance provider

Reached out to Workers Comp clients to retrieve important claim information

Responsible for updating and verifying insurances

Reviewed commercial, government, medi-care & medi-cal insurances oResponsiblus websites to check members eligibility

Customer service/phones calls to providers offices regarding claims etc.

Blue Shield of California- October 2018-January 2020

Contact internal staff to verify info and occasionally contacts external entities to resolve problems

Research information to resolve problem encounters make correction to codes

Database input and maintenance

Accesses and updates many complex system screens verifies accuracy of data submitted

Processes group or member level enrollment, cancellations, and assist with related clerical duties

Customer Service heavy phones

Data Specialist

April 2017 – March 2018

United Healthcare

Implement new provider networks and maintain necessary network access levels in accordance with internal external performance standards

Communicated contract terms, reimbursement rates, benefits to provider community

Initiated, generated, and tracked provider service agreements, amendments, or letters of intent from initial draft to full execution

Coordinated preparation and routed documents to complete the contracting process in a timely manner

Ensure executed contracts are administered timely and accurately

Performed entry of provider and vendor information to ensure accurate rosters and overall data integrity

Followed and supported guidelines set by the department and organization to ensure overall goals are met

Customer Service experience heavy phones to providers offices

Claims Processor

April 2016 – October 2016

Kaiser Permanente

Monitor daily incoming claims and processed incoming claims

Data entry and authorizations according to procedures

Kept daily log of productivity and escalated issues to supervisors as needed

Customer service- phones calls to providers offices regarding incoming claims

Lead Billing Specialist

March 2012 – September 2013

NetSmart

Managed daily task of verifying patient’s insurance policy, preparing and submitting eligibility claims

Conducted billing using ICD-9 and CPT coding

Conducted daily and monthly balance and controls reports

Medical Biller

July 2011 – March 2012

Apollo Health

Oversaw final resolutions on Medicare and Medi-Cal claims

Submitted payment errors for Medicare/Medicaid remittances

Created rejections and denials letters for patients

Stayed current with Medicare regulations and procedure as well as flexible with departmental and client changes

Administrative Assistant II

April 2008 – May 2011

Blue Shield of California

Oversaw day to day operations claims

Validated Medi-care balances and verified responsible party for Medi-care claims

Payment submissions for patients to claims providers

TECHNICAL SKILLS

MS Word, Excel, Internet Explorer, Outlook, Chartmaxx, IDX, Medisoft, Med Asset, IBEX, Brightree, Med Force, Avatar, MS-Prodscal, MS400 Bay, Meditech,Epic,Citrix,Onbase

Working knowledge of AS400, ICD-9/CPT coding, SMS, and PMOC

EDUCATION

Bryman College

Medical Assistant Program 04/1998

Hamilton High school

High school Diploma 06/1994

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