KIESHYA BRADLEY

adwtit@r.postjobfree.com

919-***-****

*Career Objective: Acquire a management position within the company that will utilize

Job skills experience and promote individual opportunity and professional growth, while

Making a positive impact and contribution to the company.

*Computer Experience: Microsoft Word, Microsoft Excel, Visual, People soft, Lotus Notes,

Internet and AS400, Prism, Med Flow, Oacis Practice partner, HPF. Power Point. Outlook Email and Calendar, Pdf Zoom, Share Drives, Doc Sign, Share Point. Image-Now, PC7 Doc Review. Pivot Tables, Epic, FTP, V Lookups FileZilla, Skype, MMIS, Teams, Imagine, Way Star, Admin, Artvia OneSource, VMwhare.

CUSTOMER SERVICES Dial America 12/2021-11/2022

Answer calls with US Bank Unemployment in different states.

Help Customer with any question they have regarding There Accounts.

Look into account that may have Fraud on them.

Closed and issue out new cards when Necessary.

Assist the Customer with any question or Issues they had regarding there Statements.

CUSTOMER SERVICES IHG 04/2018-05/2020

Answer calls and make Reservation for Hotels

Review and give the best options for room that best meets travel needs.

Help the Customer with any issues they may occur during the Hotel stay.

Always try to offer the best package deal while trying to book our Hotels

EMPLOYMENT

QUALITY ASSURANCE ANALYST CHANGEHEALTHCARE 08/18-Preseent

Monthly reports are Ran to make sure that Accounts are worked correctly.

Make sure that payments and LOA are taken on Accounts and cycle down to the patients.

QA monthly Offshore Vendors 60 -100 Accts per day

QA monthly Onshore Agents 60 Accts per day.

Must pass 3 Round with Score of 97% or better.

Make sure that Refunds are correctly sent to the patient and Insurance in a timely manner.

Assist in New Hires Tickets with Missing Lunch, PTO, Clock in Clock out Punches Via Kronos.

Respond to letters and emails from customers promptly, paying close attention to detail as well as adhering to program specific policies

Work with the operations team in order to prioritize and resolve the most critical claims, billing and payments issues as they arise;

Contact payers for medical claims status, follow up denials, or partial payments

Report any Error Trends to Upper Management.

Answers Accounts Receivable phone inquiries

QA Monthly Chart Swap, Edits, Charge/Demos, Payment posting, CORR, A/R, Credit Balance, Era.

Worked any Account within a 60 90 day period with Patient Issues to get them resolved.

Research any Missing Payments on Patient Accounts Received by Client Managers.

optimizing operational productivity, efficiency, and effectiveness. The Analyst Take direction from the WFM supervisor and work directly with AR supervisors

Verifies, adjusts, and updates Accounts Receivable (A/R) according to correspondence received from insurance company

Work Closely with Off Shore Vendors for Patient Accounts were worked in a Timely Manner and HIPPA Guild Lines were Followed.

Insure that Offshore has Demonstrated and understand the various of QA procedures and Product that is required from or Clients in The Pathways.

Train new Employees on the QA process and the Guild lines and Client Pathways.

Update Management on Issues that I may come Across on the QA process and come up with a solution for better process.

Review all Insurance Denials make sure Accounts are Handle Correctly.

Review Appeal Process to make sure Correct Document is Uploaded and process before going out the Payor.

Verifying correct billing codes and applied to be covered under Patient insurance.

Verifying maximums and deductibles amounts.

Mckesson Corporation 04/02- 08/2018

Senior AR Specialist

Customer Services Team Lead

Team Lead Medical Billing

AR Specialist

Payment Posting Dept

Work close with client and management on all areas of clients.

Attend Daily Calls with Clients/ Client Managers

Work on A/R Accounts that Denied from Insurance.

File Appeals needed on Accounts for Processing.

Update and Correct any Accts returned for Bad Address,

Scrub Claims for Errors before filing out to Insurance.

Work closely with client’s on resolving issues.

Assist in supervise 15-20 Employee’s.

Identify and problems/trends and solve and communicate them to my Supervisor.

Open up Tickets for new Employees for Access for systems.

Assist in Customer Services Call center/ Maintaining phones lines and abandon rate.

Excellent organizational, oral and written communication skills.

Run English and Halley Repot. Work Halley Errors.

General knowledge in posting recoupments and reversals.

knowledge of excel spreadsheets.

Experience with Accounting, EFT /ERA.

Post payment from Carrie Websites.

Post Self-pay and Credit Cards Payments.

Post Medicare Payments in Admin from Way Star.

Run Daily English on ERA Fall Outs.

Work with supervisors and staff employees to drive efficient call volume activity and Talk and Hold Time.

Returned Calls for Patience with Balance Issues on there Accounts.

Assist will call over load when needed to Assist my Customers Reps.

Strong claim knowledge/understanding as well as solid presentation, communication, facilitation, team building and decision-making skills.

Assist in the Training of New Employees.

Run Reports for Onshore and Offshore Vendors to Work on Dily Bases.

Post Payments/Locate Missing Payments on Accounts.

Proficient in Medicare/ Medicaid Governmental regulations pertaining to billing.

Thorough Knowledge of commercial insurance, BC/BS and all governmental carriers.

Sort and Batch Incoming Charges and Demos for processing.

Key Incoming Charges to the Interface.

Work Control Accounts to locate Missing EOBS

Work Refund Report per the Client to Verify if Refunds were Submitted to Correct Payor’s.

Setting up Referring Physician in VAR/PIM utilities.

Mapping Referring Physician in PIM Interface.

Mapping Referring Physician in VAR Interface.

Add 76/26 Modifier on Processing Claims as needed.

Run Monthly Reports to check on days in A/R.

Research and resolve accounts appearing on reports.

Work account over 30/60/90 days old and try to resolve payment on them.

Work with client on Pre-Collect reports.

Appeal necessary accounts for processing.

Work all Medicare, Medicaid Account that would Kick out or Clearing house for processing.

Follow-up on Verification process for patient Insurance to verify Eligible on Date of Service.

Assist in Call Take over for Patients that were having Issues with Billing .

Apply Medicare allowable on accounts that are needed for payment.

Return Calls from Insurance Company on Patient Insurance Inquiry Issues.

Verifying correct billing codes and applied to be covered under Patient insurance.

Verifying maximums and deductibles amounts.

HEALTH INFORMATION SPECIALIST (ROI) MUSC (IOD) 04/11-02/12

Respond to phone calls from medical and support personnel requesting medical records or patient identification to be read from the record.

Log medical record requests into MRO database.

Determine records to be released by reviewing requestor information in accordance with HIPAA guidelines and obtaining pertinent patient data from various sources, including electronic, off-site, or physical records that match patient request. Scan medical records into MRO database.

When required, respond to walk-in customers requesting ROI information and log information provided by customer into MRO database.

If necessary, respond and process requests from physician offices Attonery offices, Patient Request on a priority basis and fax information.

Comply with site facility policies and regulations.

Escalate issues to manager that delay timely release of records.

Log medical record requests into MRO database.

Determine records to be released by reviewing requestor information in accordance with HIPAA guidelines and obtaining pertinent patient data from various sources, including electronic, off-site, or physical records that match patient request. Scan medical records into MRO database.

When required, respond to walk-in customers requesting ROI information and log information provided by customer into MRO database.

If necessary, respond and process requests from physician offices on a priority basis and fax information to the physician office.

Comply with site facility policies and regulations.

Escalate issues to manager that delay timely release of records.

Performs quality checks on all work to assure accuracy of the release, confidentiality, and proper invoicing.

REIMBURSEMENT HILL-ROM COMPANY 07/01-04/03

Process and sort mail coming to Appeal Department.

Edit Dollar Adjustment.

Handle all Medicare/ Medicaid appeal letters.

Process FIS report and CBI reports.

Run end of month reports.

Assist in phone overload.

Copies, scan, and fax necessary documents.

COLLECTION/CREDIT OSI (AT&T) 07/00-04/01

Provide customer assistance in settling delinquent accounts.

Process called within the inbound and outbound call center.

Communicated with Residentail and Business customers.

Assist trainees with proper telephone etiquette.

Assist in time keeping.

Post payments.

Set customers up on payment plans.

Average 200 calls within inbound call canter / 100 calls in the outbound call center.

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