CHENELL TYNER

**** ******** ****, ***** ***** PA 19082

267-***-**** • adut9k@r.postjobfree.com

Summary

15+ years of medical claims and client servicing for health care plan providers, excellent administrative skills. Garnered promotions and recognition for consistent, high quality claims processing performance. Skills & Expertise

Proficient in Microsoft Office, Data Entry, Medical Billing, Facets and Macess systems. Strong administrative, communication and interpersonal skills, Expertise in coordinating with medical insurance providers and Human Resources. Skillful in Epic, Midas, Huron, SMS, EDM operating systems. Envision Healthcare Conshohocken, Pa

RCM Accounts Receivable Representative 02/2022-Current

• Accurately document system notes regarding any actions or updates made by patient’s account.

• Serve as a primarily contact for all inbound calls from all insurance company

• Compose appeals letters to the third-party payors sending medical records, denial letter and claim form

Force Staffing Agency /Temple Hospital Philadelphia, Pa Clinical Appeals Coordinator/ Medical Record Clerk 08/2018-06/2020

• Review, process patient cases information for appeals approval or denial.

• Proficient in data entry on Epic, Midas, Huron operating systems.

• Conducted administrative tasks and provided office support.

• Collecting patient information, issuing medical files processing admissions and discharge papers. AmeriHealth Caritas Philadelphia, Pa

Claims Examiner 07/2012- 04/2018

• Provided executive administration support to teams of 25-30+ employees.

• Handled assessments and authorization for high net value claims.

• Attended and conducted department planning meetings.

• Prepared detailed reports and handled special projects as required.

• Provided onsite training, supervision, and oversight for additional employees. Provider Claims Representative 06/2006 – 07/2012

• Handled direct client servicing for assigned regional South Carolina providers.

• Handled special project of reprocessing recalled claims.

• Utilized Facets and Macess software effectively to process claims.

• Reviewed and processed Hospital and Medical claims appeals. Claims Examiner 09/2002-6/2006

• Performed data entry to perform medical enrollments.

• Processed medical and hospital claims for payment.

• Reviewed claims and resolved discrepancies effectively. America’s Choice Health plans Valley Forge, Pa

Accounts Receivable Specialist 06/2000-09/2002

• Maintain update billings system.

• Generate and email invoices to clients

• Perform accounts reconciliation.

• Escalate problems or concerns to supervisor

Price Coordinator/Claims Data Specialist 09/1997 – 06/2000

• Reviewed and processed dental and medical claims.

• Provided client support and verified procedure pricing.

• Liaison for communications with third party providers to gather plan information. VOLUNTEER EXPERIENCE

Counselor/Volunteer - Willow Terrace Nursing Home, Philadelphia Pa Aid and companionship to senior residents. Facilitate and assist religious and social activities. EDUCATION

Microsoft Office Training & Development Program Certification Star Technical Institute, Upper Darby, Pa

Business & Medical Data Processing Training /Medical Billing and Coding Advance Career Training Upper Darby, Pa

High School Diploma

Simon Gratz High School, Philadelphia, Pa

References Furnished upon Request

Contact this candidate