MISTY M SAMPLE

**** ******* **** *****, ************, IN 46226 317-***-**** aduhum@r.postjobfree.com

Objective

My objective is to obtain a position, which will allow me to use my knowledge received with WellPoint Inc., and where my educational background will be put to best use.

Experience

EXECUTIVE DIRECTOR

2021 – PRESENT Mount Moriah Missionary Baptist Church, Indianapolis, IN

Attend meetings and training classes representing the Pastor.

Assist with the daily clerical functions of the church.

Grant Writing for Mount Moriah Missionary Baptist Church.

Assist with creating outreach programs for the community.

Assist the Pastor with daily functions

DIRECTOR

2017-2020 Angel Care Child Development Ministry, Indianapolis, IN

Oversee the daycare facility to ensure that children have a safe and fun environment to learn and socialize with others.

Process payroll

Collect payment from parents

Work with the State of Indiana to ensure that the childcare was up to standard

Assist childcare teachers when needed

Prepare lunch and snacks daily

Work with vendors to assist with the needs of the childcare

SCA AUDIT & REIMBURSEMENT ANALYST

2016-2017 National Government Services, Anthem Inc., Indianapolis, IN

Audit provider Medicare cost reports by performing the following:

Review provider bad debt listing

Review settlement data in accordance with CMS regulations

Review provider claims to ensure accuracy of bad debt claimed

Adjust amounts per audit in accordance with CMS regulations

Contact provider to receive all necessary information for review

Complete Continuing Education Training (CET) to further knowledge

Assist providers with understanding what is needed for the review

Assist team members and leads with daily duties

NETWORK SERVICE SPEC

2014 – 2016 Anthem Inc., Indianapolis, IN

Assist Contractors, Provider Relation Reps and Specialist with daily duties

Organize contracts and provider documentation for imaging

Assist providers with questions regarding provider contracts and liability

Answer customer service questions regarding provider contracts

Prepare welcome letters for provider joining Anthem networks

Assist the Utilization Management Department with appeals

Make sure the provider information is properly updated

Give excellent customer service

CUSTOMER CARE ADVOCATE II

2008-2014 Anthem, Inc., Indianapolis, IN

Assist members and providers with questions and concerns regarding member claims, benefits, and eligibility.

Process member claims to pay according to the member's benefit.

Process COB claims to pay correctly according to the member's benefit, BPM Framework inquires NF06s (communication between the Home and Host Plans), Out of Sync transactions to ensure that member’s accumulators are calculated correctly, complete Proration Reports, train co-workers to complete Proration Reports, train co-workers and management staff on COB claims and functions, adjust member’s over applied accumulators, and respond to Secure Provider Emails.

Assist fellow teammates, OEs and ESRs with various questions regarding claims and phones

Assist with keeping inventory to a minimum

Audit new processor’s claims

Give excellent customer service

Excellent teamwork skills

Education

INDIANA WESLEYAN UNIVERSITY, Indianapolis, IN

2004-2012

Bachelor of Science Degree in Accounting

National Deans List 2006-2007

GPA 3.2

INDIANA WESLEYAN UNIVERSITY, Indianapolis, IN

2012 – Present

Master of Science Degree in Management

References

References are available on request.

Contact this candidate