HOPE CARTER

advdcq@r.postjobfree.com 470-***-**** Columbus, GA 31904.

Skills

●Medical Billing

●Medical Terminology

●ICD-10

●CPT

●Claim Entry

●Payment Posting

●Insurance Verification

●Customer Service

●Communication

●Time Management

●Problem Solving

●Rapport Building

●Attention to Detail

●Cash handling Expert

●Cultural Awareness

●Numeracy

●Data processing

●Data entry

●Microsoft Office

●Organizational skills

●Data input

●Data transcription

●Collecting information

●Typing manuscripts

●Microsoft Office expertise

●Email communications

●Filing and data archiving

●Advanced clerical knowledge

●Administrative support specialist

●Spreadsheet management

● Point of Sale Knowledge

●Appointment scheduling

●Insurance company knowledgeable Payment processing

●Regulatory compliance

●Appointment confirmation

●People skills

●Critical thinking

●Conflict resolution

●Data evaluation

●Customer relations

●Problem-solving abilities

●Clerical

●Logbook updates

●Excel expertise

●Spreadsheet creation

●Verifying data accuracy

●Error identification

●Data collection

●Technologically savvy

●Inbound and Outbound Calling

●Retail sales customer service

●Call Center Operations

Project management abilities

Experience

Goldfein Alpharetta, Ga Current

Claims Negotiator

●Researched and reviewed information to determine validity of insurance claims and contacted companies and customers about decisions.

●Delivered quality customer service to assigned, insured and claimants throughout the entire claims lifecycle to promote service times.

●Keys transactions, verifies accuracy, and performs routine math calculations

●Supported efficient handling of complex claims and followed up on open, denied or suspended claims to complete required line items.

●Adheres to established policies and procedures and recognizes deviation from accepted practices

●Reviewed documentation and accounts to gain a full picture.

●Monitored reports to identify claims issues and worked with adjusters to resolve problems.

●Negotiated settlements for uncomplicated claims in accordance with actual company liability.

●Managed asset recoveries for claims, including salvage and subrogation.

●Followed all company procedures to keep data confidential.

●Gather proper documentation and data to prepare claims for submission.

●Assessed processing reports each day to effectively submit claims.

●Investigated claim and settlement deals and reviewed coverage determinations.

●Created master spreadsheet to record procedures, denials and approvals.

ST. Francis Columbus, GA

Medical Billing and Coding Specialist

●Provided administrative support to physicians and interpreted data to assign ICD-9.

●Entered CPT codes and patient information into billing software.

●Reviewed and validated accuracy of charges including dates of service, services provided, location and provider signature.

●Assigned ICD-10 to physicians diagnosis and insured the correct level of service and various other CPT codes.

●Connected with Insurance and patient aging to resubmit insurance claims when necessary.

●Applied HIPAA privacy and security regulations while handling patient information.

●Verified demographics and insurance information to register patients in the computer system.

●Organized and maintained records by updating and obtaining both personal and financial information from patients.

●Obtained necessary signatures for privacy laws and consent for treatment. Assembled registration paperwork and placed identification bands on patients.

●Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations. Processed patient responsibility estimate determined by insurance at pre-registration.

●Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans.

●Communicated financial obligations to patients and collected fees at time of service.

●Responded to patient concerns and inquiries professionally and efficiently.

●Obtained health, financial and religious information from patients at time of admission.

●Scheduled and implemented patient admissions and discharges. Received patient inquiries or complaints and directed to appropriate medical staff members.

●Addressed patients' complaints-head on, investigated concerns and worked with medical staff to devise solutions.

●Helped patients obtain health care services by setting up referrals. Facilitated communication between patients, medical and administrative staff, administrative staff and regulatory agencies.

●Identified, corrected and reported data entry errors.

●Completed accurate and efficient data entry and database updates to support business operations.

●Input client information into spreadsheets and company databases to provide leaders with quick access to essential client data. Compiled data from source documents prior to data entry.

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Global Payments Columbus, GA Data Entry Clerk

●Input client information into spreadsheets and company databases to provide leaders with quick access to essential client data.

●Identified and corrected data entry errors to prevent duplication across systems.

●Reviewed and updated account information in the company computer system.

●Adhered to strict data confidentiality policies to prevent information leakage.

●Proofread documents and edited materials to correct grammar and spelling mistakes.

●Maintained quality levels above prescribed minimums to support team productivity.

●Verified and logged deadlines in response to daily inquiries and requests.

●Compiled, sorted and verified digital data against source documents.

●Updated departmental standard operating procedures and database to accurately reflect current practices.

●Reviewed source documents to locate required data for entry.

●Compiled and documented statistical information for reports.

●Performed imaging, transcription and verifying tasks to keep office workflows running smoothly.

●Coordinated, scheduled and executed in-depth data entry projects.

●Reduced physical document storage footprint by scanning and eliminating outdated records

Aflac Columbus, GA

Claims Specialist

●Researched and reviewed information to determine validity of insurance claims and contacted companies and customers about decisions.

●Contacted policyholders, claimants and witnesses to determine liability in auto accidents.

●Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.

●Researched coverage and premium options and supplied clients with best coverage available for individual needs.

●Oversaw regulatory and strategic initiatives to ensure accuracy of medical claims.

●Investigated and analyzed requirements to improve timeliness of reports to customers.

●Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.

●Delivered quality customer service to assigned, insured and claimants throughout the entire claims lifecycle to promote effective service times for all parties.

●Verified details with policyholders and requested additional information.

●Reviewed documentation and accounts to gain a full picture.

●Assessed policy coverage and pulled contracts for review.

●Monitored reports to identify claims issues and worked with adjusters to resolve problems.

New Square Columbus, GA Sales Associate

●Arranged new merchandise with signage and appealing displays to encourage customer sales and move overstock items.

●Sold various products by explaining unique features and educating customers on proper application.

●Built and maintained relationships with peers and upper management to drive team success.

●Answered incoming telephone calls to provide store, products and services information.

●Maintained knowledge of current promotions, exchange guidelines, payment policies and security practices.

●Assisted teammates with sales-processing tasks to meet daily sales goals.

●Retained product, service and company policy knowledge to serve as a resource for both coworkers and customers.

●Offered product and service consultations and employed upselling techniques.

●Met merchandise processing standards and maintained an organized and accessible work area.

●Coordinated activities with other departments to ensure quality customer service.

●Built trusting relationships with customers by making personal connections.

●Acted as initial contact in addressing customer concerns.

●Negotiated and closed deals with minimal oversight.

VIVI Boutique Columbus, GA Sales Associate

●Built and maintained relationships with peers and upper management to drive team success.

●Answered incoming telephone calls to provide store, products and services information.

●Maintained knowledge of current promotions, exchange guidelines, payment policies and security practices.

●Assisted teammates with sales-processing tasks to meet daily sales goals.

●Retained product, service and company policy knowledge to serve as a resource for both coworkers and customers.

●Offered product and service consultations and employed upselling techniques.

●Met merchandise processing standards and maintained an organized and accessible work area.

●Arranged new merchandise with signage and appealing displays to encourage customer sales and move overstock items.

●Sold various products by explaining unique features and educating customers on proper application.

●Coordinated activities with other departments to ensure quality customer service.

●Built trusting relationships with customers by making personal connections.

●Acted as initial contact in addressing customer concerns.

●Negotiated and closed deals with minimal oversight.

Education and Training

Chattahoochee County High School Cusseta, GA High School Diploma

05/2017

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