Data Entry Accounting Representative

Sha’ron S. Black

**** **** ****** ** *********, NC 28227 {C: 704-***-****} *********@*******.***

Summary of Qualifications:

Results oriented leader with customer service and support background, healthcare insurance and business to business development experience. I consistently strive towards effective account management and resource development amongst internal and external customers. My focus is committed to attention to detail, promoting company excellence and maintaining a high level of self-motivation along with a desire for continued success across all lines of business that I touch.

Professional Experience:

PMMC (Preferred Medical Marking Corp)

Revenue Analyst April 2020- Present

Reconciling client zero balance, aging and full denial claims

Responsible for 32 facility revenue review monthly

Consistent monthly goals of 1-$300,000 personal attainment of recovery revenue per month

2- 25 per day touches via phone, payor portal or email

3- departmental submission rate of $2M per month for client reports

Handle review and submission of patient medical records for Third Party Liability reviews, Medical Reviews and Appeals processes

Conducts DRG, ICD-9 and ICD-10 code verifications for claim rebills

Atrium Health/Carolinas Healthcare System

Patient Accounts Coordinator August 2019- April 2020

Billing for Skilled Nursing, Home Health, Rehabilitation and Infusion Therapies

oEdits all claims for accurate pricing, coding, service dates and general demographics, prior to submission to carriers

oCompletes and submits claims according to government regulations, agency policies and timeliness standards

oMonitors the processing of documentation which creates claims for various funding sources through data entry

oEnsures completion of revenue posting prior to business system monthly software closure

oPrepares aging reports of unpaid claims and collects on overdue accounts

oReviews weekly and monthly billing reports for accuracy

oReviews preliminary billing lists and payor demographics for possible adjustments or corrections

oMaintains all of the Patient Accounting functions listed below as well

Patient Accounting Representative February 2018- August 2019

Correspondence Dept:

oEpic Denials

oHyland OnBase Work Queue processing

oSorting Mail

oClaim research

Specialized Billing Dept:

oSponsored Agencies- covering 12 County, State, Government and Victims Assistance agencies billing

oClaims adjustments, billing, Commercial coordination of benefits and follow up

o

Medicare/Medicaid Hospice- processing Medicare and Hospice denials, verifying coverage through Palmetto GBA, filing Hospice/Medicare/Medicaid and Med Advantage plans, follow up on claim status and payment

Facility Billing Dept:

oBilling Skilled Nursing facilities, clearing balance bills, processing Medicare Explanations of Benefits and Medicare denial follow ups

Maintains a consistent high productivity and quality rate> currently 14 months at 100%

Atrium Health/Carolinas Healthcare System

Registrar/PRN July 2017- February 2018

Long Term assignment handling Radiology authorizations for CMC Main location

Fully Trained in STAR and EPIC Encompass systems

Fully accessible within all insurance payor sites

BSN Medical, Inc.

Territory Business Manager, Consumer Health- Georgia September 2014- June 2016

Establish and maintain viable business relationships as a trusted advisor thru sales calls and field travel in Georgia territory

Consistently met and exceeded selling goals of new and existing products

Handled sales buyouts, store merchandising, physician in-servicing and insurance network building and cash sales management

Corporate Sales Representative February 2009- September 2014

Established and maintained business relationships as a trusted advisor via sales calls and field travel

Consistently met and exceeded selling goals of new and existing products

Provided training and continued mentoring to new members of sales team

Exceeded $2 million in gross sales over a 32-month period in Tier 4 areas (lowest volume potential)

Maintained 8 straight months of $100,000+ in sales

SKILLS:

Fully versed in PPO and HMO products

Fully SAP and CRM disciplined

Microsoft Office Proficient

Full Claim Source capabilities

Fully EPIC-Encompass disciplined

CRCS-1 certification via AAHAM in November 2019

References available upon request

Contact this candidate