Mail Processing Office Assistant

Location:

Southport, NC

Posted:

March 18, 2023

Contact this candidate

Resume:

Celeste Alamond

*** **** **.

Southport, NC *****

Ph: 607-***-****

E-mail: *******@*******.***

SUMMARY:

NC Medicaid Provider Enrollment/Hearings & Appeals/CMS and OIG Monitor and Reporting Medical Office Assistant/Medical Records HIM Analyst/Coding, Billing, Special Education Software Trainer/Support Special Education & Medicaid Compliance, Medical Biller/Trainer for students with disabilities. NY State Service Coordinator Certificate Trainings Executive-level support, sales, and marketing support Coastal Horizons Center Inc – Provider Credentialing Manager 11/2018 – Present Manage credentialing department, credential providers according to their licensures including PHPs, Commercial and LME/MCO companies. Other duties may include purchasing, invoices, research, assist billing department with denials, terminations, maintain databases and electronic documentation including provider charts NC State DHHS Medical Assistance - Medicaid - Raleigh NC 2017 - 2018 Provider Services Coordinator – Specializing in Provider Enrollment/Hearings & Appeals, working with Program Integrity, PEGA, PCG, CSRA (NCTracks). Provider hearings and appeals, research, write summaries necessary for hearings according to Federal regulations and State Laws, For Cause Denials & Terminations & Reporting to OIG, Program Integrity back-up - Microsoft Office Excel, Power Point, Word JOHNSTON UNC / CZ BILLING – 2016 - 2017

Medical billing and coding - physician office family practice Patient Information Coordinator

Release of information to patients, law enforcement, attorneys and other healthcare facilities utilizing EPIC, Intranet, Internet

Dosher Memorial Hospital, Southport, NC - 05/2016-01/2017 HIM Analyst-Medical Records

Release of health information, scan, fax, mail, and release records and processing records in-house and for satellite offices, coding ancillaries and radiology for billing utilizing CPSI & 3M Coding Software Chemung County - GST-BOCES, Elmira, NY – 07/2010-09/2015 Computer Program Assistant - Special Education Software Trainer Support Provide first-line software support to school districts troubleshooting computer problems related to basic software, hardware, and security. Train and support service providers and school district staff, billing of OT, PT, SPEECH, PSYCH, and Nursing - students with disabilities / Medicaid Billing Insurance Clerk-Medicaid Service Team Interpret and communicate Medicaid and Part 200 Special Education policies and procedures. Maintain, store process records, facilitate turn-key trainings for compliance: Clear Track, IEP Direct, CNYRIC, Med Web, Billing Sheet Programs, Microsoft Office, NYSDOH web-site

School District Contractor Multiple Therapies Co – Waverly, NY - 06/2008 -07/ 2010 Medical Office Assistant and Early Intervention Therapy Services Coordinator (in-training) - New York State Department of Health-Early Region 4/5 (Early Intervention Coordinator)2007– 2008 for children with IFSPs and IEPs - http://www.eilearningnetwork.com. Payroll, purchasing /therapy equipment maintenance, liaison between counties, school district, and providers Medicaid and direct billing to schools, counties, credentialing, certification updates, Insurance/Medicaid enrollment, training, managed aspects of HR including trainings, health insurance, Workers’ Compensation, company vehicle insurances, 403B, annual contracts – schools, client/patient liaison, scheduling, records maintenance, NPPES, licensure, all aspects of provider credentialing/enrollment PAXAR CORPORATION, Sayre, PA - 2000 - 2007

Marketing Assistant, Human Resources, Service Engineers Engineering Field Service Help Desk - point of contact for Engineers, marketing, customer service, and field service managers. Organize, create, and distribute sales communications, logistics, marketing intranet site maintenance, purchasing, mail, shipping (UPS, USPS, FedEx, DHL) volume reproduction, proof reading, editing, copying and mass mailings, travel, and scheduling. Oracle, Microsoft Office, Contribute, Contribute II, Photoshop, Dreamweaver, Microsoft Publisher (Recognized by Paxar for initiating sizable purchasing cost savings by research, presentation and implementation)

GUTHRIE CLINIC, LTD, Sayre, PA - 1997 - 2000

Medical Office Assistant/Occupational, Environmental, and Employee Health Support Scheduling, Complete all insurance forms on behalf of patients for Medicaid, commercial insurance, Case Manager back-up-Liaison between employer and physician for employment physicals, drug pre-screenings, documenting charts, forms processing, labs, coding superbills. Microsoft Office, DOS, Lotus, EPIC SEARS AUTOMOTIVE, Horseheads, NY, Johnson City, NY - 1993 - 1997 – Part-time and seasonal Certified Automotive Sales Representative

Sales of automotive parts and service, hourly plus commission IBM, Lockheed Martin, Loral, Datrose - Owego, NY – 1991-1993 – 2 year temp./contractual 1 year Administrative Assistant-Engineering - scheduling, purchasing, reporting (Datrose at IBM) Department mail room coordinator 1988-1989 (Temp)

Mail Room-computerized reports, mail processing, reporting, distributions and shipping, specialized map printer Computer Center/Tape Drive Operator 1984-1985 (Temp) Tape drive operations and computer center utilizing PROFS, CMS, VM, CADAM, SEQUEL, MVS, DOS software programs, Lotus and IBM computerized tape drives for end-users EDUCATION

Elmira Business Institute-Elmira, NY - 2008

Degree - Coding/Billing/Business-(AAPC CPC, Alpha Beta Kappa, 3.9gpa 2008) Medical Terminology, Anatomy and Physiology, Medical Law and Ethics, Professional Coding I, and II, Medical Office Procedures, Medical Billing I & II, Health Care Reimbursement, Health Information Management, Internship - Tioga County Mental Health Department 2008 Processing private and Medicaid insurance claims accessing Medicaid EPACES, verification of eligibility and billing software-HCFA 1500 and UB04 forms after sending electronically through IVANS Business Certificate – Broome- Tioga BOCES, Binghamton, NY - 1982

MEMBERSHIPS & CERTIFICATIONS

American Academy of Professional Coders Association/Certified Professional Physician Coder - 2008–Current Local Chapter VFW Boiling Spring Lakes, NC – 2015 - 2019 First Responder - Volunteer (2004-2005), International Management Council (2001-2002) REFERENCES

Darryl E. Frazier

Manager Division of Health Benefits

NC Department of Health and Human Services

Office: 919-***-****

Fax: 919-***-****

******.*******@****.**.***

801 Ruggles Drive, Hoey Building

2501 Mail Service Center

Raleigh, NC 27699-2501

Amanda Valentine

Enrollment Specialist, NC Medicaid

Division of Health Benefits