Healthcare/Disability Claims

Melvin Ancrum

Austell, GA *****

470-***-**** ******.******@*****.***

PROFESSIONAL PROFILE

Customer service-oriented professional who provides technical assistance and application support. Possess skills necessary to communicate solutions and provide guidance and problem-solving assistance. Attention to detail necessary to ensure the quality of documentation in patient medical records.

Academic Honors Recognition / Honor Roll

Configure and troubleshoot healthcare software, help keep health records secure, and operate a help desk

Maintain operations according to established standards, policies, and procedures.

Assess, interpret, and analyze customer technical problems.

Microsoft Office Applications / MS Word MS PowerPoint

3M Coding and Reimbursement System Meditech (EHR) – McKesson – Cerner EHR EDCO SolCom EDMS

Nuance Clintegrity Facility and Physician Coding, Compliance, and Abstracting

ARGO Enterprise Master Patient Index CIOX Health ROI – eSmartlog and SmartLink

Skype Hercules Jabber NetOp ServiceNow SafeNet

KEY QUALIFICATIONS

Health Information Management (HIM) Medical Records Management Release of Information (ROI)

ICD Coding CPT Coding Health Information Technology HIPAA Compliance Medical Terminology

Document Scanning Data Quality Data Management Data Entry Medical Records

Computer Office Applications Electronic Health Records (EHR) Electronic Medical Records (EMR)

Medical Administrative Support Medical Office Procedures Insurance Verification Filing

Pharmacology Anatomy & Physiology Reimbursement Procedures

Medical Laws & Ethics Customer Service Interpersonal Professional Communications Imaging Record Technology

EDUCATION

Ultimate Medical Academy Associate of Science Degree – Health Information Technology, 2022

Ultimate Medical Academy HIPAA Essentials for Healthcare Professionals Certificate

WORK EXPERIENCE

Sedgwick Healthcare Claims 12/2022-Present

Medical Biller/Leave of Absence Specialist

Supports and promotes all integration initiatives (including Family Medical Leave, Life Assistance Programs, Integrated Personal Health Team, Your Health First, Healthcare Connect)

Administers Family & Medical Leave Act (FMLA) standalone claims (related to childcare, family member illness/injury or employee illness/injury not associated with a Group Disability claim)

Coordinate non-salary employee compensation like retirement plans, pensions, tuition reimbursement, and stock options

Process various paperwork, especially regarding disability, FMLA absences, and employee life status changes

Accurately assign ICD and CPT codes to patient medical records.

Review patient charts and identified discrepancies in the medical documentation.

Analyze DRG assignments using ICD-10-CM codes.

Communicate with insurance companies regarding the updates in invoices.

Perform computer assisted coding (CAC) using radiology information systems.

State Farm – Smyrna, GA 08/2021 – 11/2022

IT Support / Customer Service

Assist employees with access, VPN, networks, printers, and mapping drives

Handle inbound and outbound phone calls and familiar with command prompt

Utilize NetOp software, Service Now for ticketing system, and SafeNet for password resets and to verify employee identities,

Operate Jabber for outbound phone calls for the employees, Skype for phone and contacting, and Hercules software for inbound phone system

Deal with bitlocker for encrypting the computers

Ultimate Medical Academy – Austell, GA 08/2020 – 01/2022

Full Time Student

Remained self-directed, motivated, and accountable for personal actions

Came prepared for class and completed assignments on time

Navigated new technology, utilized available resources, and set realistic expectations

Aveanna Healthcare – Marietta, GA 09/2019 – 07/2021

NOC Analyst

Provided timely response to all incidents, outages, and performance alerts

Categorize issues for escalation to appropriate technical teams

Recognized, identified, and prioritized incidents in accordance with customer business requirements, organizational policies, and operational impact

Collectand review performance reports for various systems and report trends in hardware and application performance to assist senior technical personnel to predict future issues or outages

Monitored a wide variety of information and network systems that included, but were limited to telecommunications circuits, LAN/WAN systems, routers switches, firewalls, VoIP systems, servers, storage, backup, operating systems, and core applications

Documented all actions in accordance with standard company policies and procedures

Notified customer and third-party service provider issues, outages, and remediation status.

Worked with internal and external technical and service teams to create or update knowledge base articles.

Performed basic systems testing and operational tasks and supported multiple technical teams in 24/7 operational environments with high up-time requirements.

Northside Hospital – Atlanta, GA 09/2018 – 08/2019

IT Go-Live Analyst

Answered inbound phone calls and met current service level agreements.

Remained familiar with Service Now Ticketing System

Hands on with Command Center Go Live Implementation from McKesson to Cerner EHR

Utilized customer service skills along with strong communication, phone presence, and professionalism.

Ensured SLA abandon rate of less than 5%

Wellstar Hospital – Marietta, GA 10/2017 – 08/2018

Service Desk Analyst

Supported 8,000 new users on technical issues related to hardware, applications, and systems

Received 40 – 50 inbound calls for Tier 1 Support for 5 new hospitals that implemented a new EHR (Electronic HealthSystem) for EPIC

Answered inbound calls pertaining to “How To” instructions for EPIC system

Worked with end users on understanding technical issues via phone to document and escalate within Service Now ticketing system

Maintained calls within an average 8-minute talk time with a 30 second or less average speed to answer and stay within a less than 3% call abandonment rate as a team

Verified user pertinent information to authenticate user’s profile

Assisted users that were experiencing problems with remote access from their PCs at home by providing technical support and working with Symantec PGP

United Healthcare Group - Optum 10/2015 – 09/2017

IT/ Customer Service Support

Responsible for providing technical telephone support, answering inbound calls from clients concerning

login issues with client portals. Respond to issues appropriately and answer questions on function and

usage of products

Document details of customer interaction by opening ticket within CRM system and record appropriate

information in database

Perform follow-up testing, and/or troubleshooting to assist customers with the most accurate and timely

response for their technical support issues.

Possess thorough knowledge of all portals and other applications utilized by customers.

Direct unsolved technical issues to appropriate departments and personnel.

Guide the user through a series of steps to determine the problem, prioritize and ascertain the nature of

complex equipment problem.

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