Medical Billing Client Services

SHARON E. MAGEE

Denver, Colorado 720-***-**** *********@*****.***

CLIENT SERVICES • ADMINISTRATIVE SPECIALIST • PLANS, BENEFITS, BILLING & CLAIMS • TROUBLESHOOTER Expertise in Performing In-Depth & Accurate Research, Investigation, Analysis and Review Organized, Meticulous Attention to Accuracy, and Sense of Urgency in Promptly Resolving Problems & Issues QUALIFICATIONS PROFILE

I bring a well-rounded and diverse background in Health Care Information Management Systems / Medical Billing & Claims, Telecommunications Solutions, Credit Analysis & Lending––skilled in troubleshooting, escalation management, with ability to navigate complex contract guidelines, protocol, risk assessment, and regulations––combined with in-depth understanding of client or members’ circumstances to provide best possible outcome for all. Core Competencies:

• Claims & Pre-Authorization Data Review • Plan / Product Inquiries / MDCR Open Enrollment

• Coordination of Benefits & Verifying Eligibility • Processing Provider Contracts

• Processing / Adjudicating Payments or Denials • Calculating Discounts, Penalties, Interest

• Medical & Pharmaceutical Terminology • Coaching New Hires & Continuing Education Training Technology / Computer Proficiency:

• MS Windows MS Office Suite (Expert on Excel Spreadsheets) • CPT, ICD-9/10 Coding, UB92 & Medical Billing

• Health Information Management (HIM) Systems (EPIC) • Financial / Credit Analysis – Mortgage Lending

• Doc Flow / Workflow Management System • Work Order / Scheduling & IT Support Key Strengths:

• Exemplify Core Values of Honesty, Integrity, Accountability, Cultural Sensitivity and Respect for Others

• Collaborative Team Player who Shows Initiative and Ability to Lead and Coach New Hires and Mentor for Success

• Focused, Organized, and Excellent Time Management / Prioritizatiion Skills; Learn Quickly and Apply New Knowledge Seeking a position that will capitalize on my strong business acumen and analytical / math skills combined with my commitment to ensuring that our clients expectations are met and doing business with our organization fosters loyalty based on trust and value. I am interested in working in the areas of financial services, credit analysis or mortgage lending. CAREER HIGHLIGHTS

KAISER-PERMANENTE - Englewood & Denver, Colorado

Accumulations Representative (2018 to Present)

Coordinator of Benefits / Claims Processor (2007 to 2013) / Claims & Referral Processor (2016 to 2018) Client Services Unit Representative / Senior Member Services Representative (2004 to 2006) Pharmacy Technician (2002 to 2004)

• Conducted quality review of claim / pre-authorization data submitted on claims, bills, and / or preauthorization data.

• Supported sales, account management, resolved purchasing issues, plan/product inquiries; liaison for all lines of business.

• Interpreted policies, processed & adjudicated medical claims; calculated discounts, penalties, interest & percent of contracts.

• Thorough knowledge of different group plans, HSA, deductible / coinsurance, Medicare, Medicaid, & other special programs.

• Received Rx orders from providers, responded to members, applied appropriate plan & co-pay; audited claims adjustements. NEXTEL / LEVEL 3 COMMUNICATIONS - Denver, Colorado Customer Service Specialist / Technical Support / Analyst & Senior Escalations Specialist (2 years) SECURITY TITLE - Englewood, Colorado / CHERRY CREEK MORTGAGE - Denver, Colorado Title & Mortgage Loan Processor (3 years)

EDUCATION & INTERNSHIPS

KAISER-PERMANENTE - Englewood & Denver, Colorado

Completed numerous continuing education programs, workshops and new technology training. SELECT SPECIALTY HOSPITAL - Gulfport, Mississippi

Health Information Management (HIM) Credentialing Manager (2014 to 2015) Application of health information data acquisition, analysis and protection vital to informing decisions for quality patient care. PARKS COLLEGE - Aurora, CO

Certificate / Diploma - Medical Insurance Billing and Coding Program Summa Cum Laude May 2005

• President’s List GPA 4.0

FRONT RANGE COMMUNITY COLLEGE - Westminster, CO

Certificate / Diploma - Pharmacy Technician Program, Cum Laude May 2002

• St. Anthony Hospital & Cub Foods - Internship Pharmacy Technician (2002)

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