Education

Lake Sumter Community College January 2021 - 2022

Medical tech

FTC College Orlando~ UCF FL July 2016

Bachelor of Science/ Allied Health Management

Maven Institute June 2005

Certificate: Medical Administration, Billing and Coding

Professional Summary

Medical professional with over Eighteen years of medical business office experience.

Healthcare insurance processing experience including claims entry, validation and resolution.

Analytical and self-motivated with ambition to succeed.

Excellent communication and interpersonal skills.

Work well with little supervision and part of a team.

Languages: English, French, and Haitian Creole

Health Information Technology and Administrative Skills

Professional Experience

Aetna Managed care / Health care insurance Orlando, FL October 2016 – June17/2021

Health Information Coordinator Clinical Representative

Ability to be empathetic and compassionate handled field inbound calls

Must assist in accordance within highest principles of fairness ethical guidelines

Provided comprehensives support for all benefits accounts types in a single platform – including FSA-HSA-HRA-dependent care, commuter, wellness incentive accounts and more. Initiate process orders per clinical/ confirmed assessment- worked adjudication rejections &quick based drugs review approved accordingly. Skilled in providing excellent customer care

Functional – Communications/ among Members inquiries – Providers – Vendors based upon request

may be made verbally as in writing / Transferred set up delivery for new and returning ASRx per clinicians internal and external in related to pharmacy benefits. Precert Authorization & correspondence letters and documented issues and resolutions in a common database

Potential TAT – Timeliness of Pre-service/ Concurrent review & Post-service review decision committed to addressing customer concerns with speed, accuracy and professionalism

Handling conflict / Evaluates decision notifications to Practitioners & Members whether

denial notification includes specific reason for the denial or used to informed an appeal rightect..

Florida Hospital Medical Group/ Health Information Receptionist March 2015 - April 2016

An experienced Customer Service Rep/ Claims Processor with excellent in processing orders, assisting with copay, referrals, and submit payment for billing. Verified registration demo and insurance, patient check in/out

Processed charges coded ICD-9/ ICD-10 Verified CPT-HCPCS Coding

Scheduled appointment and diagnostic testing, Filling electronic chart tracking

Prepping, Scanning paper records into imaging system to create permanent online

Interpreter Services in French and Haitian Creole

Connextions /AARP United Health Care Orlando, FL June 2011- August 2014

Customer Service Inbound Outbound/ Outbound

Resolve customer’s inquiries.

Assist customers with billing, health and grievance and website support.

Notate daily customer inquiries and or assistance on electronic files.

Perioperative Service Logger Biller & Coder/Certified Medical Assistant

Exhibited proficiency with med soft coding and billing, including EOB forms

Demonstrated familiarity with medical terminology, ICD-9 codes and CPT-9 codes

Provided general medical billing office services

Demonstrated proficiency as a medical assistant

Took vital signs using a tactful, direct and sensitive manner

Home Manager / Family Services of Metro Orlando (Assessment unit)

Coordinated services/monthly staff schedules, duty assignments, and care plans

Monitored staff attendance

Scheduled clients quarterly review meetings and discuss clients progress

Provided special instructions referrals

Monitored home visit statuses, and assure all resident had a written support service plan

Monitored risks to minors

Conducted client assessment and ISP

Developed ESS case plan goals

Initiated and coordinated inventory cost controls

Med Tech Support/ Registration clerk

Conducted laboratory test routines in accordance with MYSIS

Handled accounts receivable and petty cash

Merged Multi-Medical Systems records.

Verified insurance referrals/authorizations lab work requisitions

Handled co-payments, and other inquiries, answers screens

Obtained health insurance pre-approvals

Brockton, Health Center / MBC Hospital Boston, MA August 2003- August 2006

Registration Clerk, Lab Assistant, Phlebotomist

Provided primary administrative assistance

Processed lab billing codes and maintained files

Scheduled appointments for doctors abroad

Prepared and assembled new patient charts

Handled initial certification, recertification of WIC vouchers

Account Specialist II

Compiled data for reports in the TIAA CREF Fund Group

Recorded financial transactions

Reviewed accountability reports to keep records up-to date

Batch processed new accounts

Processed and verified ACH minimum Investment requirements for subsequent purchases

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