Shamell Silas

**** ******* ***** **. *****, MO **136 314-***-**** adtynx@r.postjobfree.com

PROFILE

A highly motivated and goal-oriented healthcare professional experienced in performing a variety of clerical tasks with a strong ability to efficiently perform billing activities, including verification of invoice information and maintenance of billing records, follow-up of submission of claims and resolutions; has an exceptional ability to prioritize tasks to meet goals and objectives; has a strong ability to interact and communicate with people of all levels and status. In addition, I have experience as an Unarmed Security Guard providing protection with non-lethal measures. Patrolling, monitoring cameras, handling unmarked vehicles, and checking identities.

SUMMARY OF SKILLS

Sound organizational skills includes, planning, setting priorities, multi-tasking, time management, proficient in Microsoft products, and adapting to company software

Proficient in determining eligibility requirements to maximize benefits

Correct interpretation of benefit structure regarding exclusions or additions to plans

Proven success in the denial/appeal processes; coordination of benefits

Creation and maintenance of Excel spreadsheets for various projects

Excellent communication skills, proven interpersonal skills, effective written and oral communication

Strict adherence to patient confidentiality and HIPAA regulations

Strong observation skill and excellent verbal and written skills for reporting

Trained to appropriately prevent and react to theft, vandalism, fire, and illegal activity

Trained to react to specific crisis situations effectively and efficiently when waiting for emergency services is not an option

EDUCATION

Diploma - Vashon High School College Prep, St. Louis.MO

TRAINING

Medical Terminology

IDX Training

Technology Integration Seminar,

PROFESSIONAL EXPERIENCE

Dent Wizard

Insurance Claim Representative

3/2016 –Present

Handle and resolve customer complaints specifically but not limited to those from Insurance/ Hail customers. Maintain and follow Insurance/Hail claim procedures. Answer incoming customer inquiries from all lines of customer care center business and make outbound calls. Enter and update customer information in company database

Schedule claims, sales and service appointments (email, text, phone and claims systems)

Coordinate the efforts of the service and sales teams

Provide friendly, knowledgeable, and prompt support for internal and external customers. Work to improve systems and processes to make the customer care center more effective and efficient

Coordinate work with other customer care center team members

Participate in and give feedback for evaluation and training of other customer care center team members

Assist other customer care claim center team members or manager as required. Some evening and weekend coverage may be required during peak business times.

Infinite Occasions Banquet and Conference Center

Unarmed Security Guard

9/2015- 9/2016

Developed and implemented an efficient admission process at the client’s site. Monitored all entrances and exits to ensure prevention of all unapproved entry into the facility, supervised all vehicular movement and parking. Scanned incoming and outgoing employees and clients using hand held wands. Remained calm, assertive and mindful to think critically and problem solve during stressful situations. Ensured optimal levels of communication with clients and visitors and provide all required information.

McCallum Place

A/R Collections

4/2015-7/2015

Completed the collectors work list in HMS daily. Ensured the total number accounts listed each day is reviewed, followed up on and a note documented on each account reporting what was done and what needed to happen next. Reviewed accounts in the HMS system that are missing discharge dates and updating accordingly. Reviewed the Bill Select Error report for accounts that are missing information and updated accordingly. Informed the Business Office Director about any accounts that could not be updated due to missing information.

Spruce St Parking

Parking Lot Attendant

6/2014 – 3/2015

Secured personnel and premises by inspecting buildings, patrolling property and monitoring surveillance cameras. Warned violators of rule infractions and escorted unauthorized persons off premises. Responded to and thoroughly investigated all reported incidents to protect company assets. Deterred criminal activity, vandalism and general misconduct by providing expert and highly visible security presence at facilities within view. Provided friendly and professional assistance to employees, visitors and customers. Collected parking lot fees from customers and issues parking stubs. Patrolled parking areas and monitored car safety to prevent theft and damage. Exceeded customer satisfaction by finding creative solutions to problems.

Washington University School of Medicine

Insurance Biller Collector II

2001-2014

Performed collection follow-up duties for third party payers, (HMO/PPO) ensuring timely and accurate payment of physician charges for the following departments: pediatrics, radiology, internal medicine and ophthalmology. Contacted insurance companies regarding payment delays. Utilized payer’s websites for claim status, policy information, and communication. Contacted patients via telephone and written correspondence when additional information is needed from patient to process claims. Posted and reconciled contractual adjustments. Ensured the accuracy of claim; verified correct ICD-9 and CPT codes were billed. Submitted secondary claims upon processing primary insurance. Updated patient registration as needed.

Barnes Jewish Hospital

Medical Office Clerk

1999-2001

Maintained patients care by compiling, reviewing and filing documentation. Ensured medical records were complete and accurate. Assembled charts in standard in ordered and filed documents accordingly. Provided medical record information as needed. Answered and processed request for medical records by departments and patients. Scanned and performed quality review to assure that all documents were properly identified Maintained confidently of all accessible, patient financial, and medical record information. Resolved medical record discrepancies

Excellent Reference Available Upon Request

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