Data Entry Customer Service
Resume:
Senior Analyst and Auditor Specialist
Objective
To secure a challenging and rewarding position as a remote worker data entry, billing auditor, or agent where my skills, industry experience, and customer service expertise can be utilized to ensure prompt response in service experiences for employers, patients and maximize profits for the establishment that I am employed with.
education
Tidewater Community College
Chesapeake, VA 23322 August 19, 2005 till Current
Administrative Support Technologist (AST)
English 111 grade 4.0
Medical Office Management and Procedures grade 4.0
Medical Terminology I, II grade 4.0
Keyboarding I, II, III grade 4.0
Word Processing 2003 grade 4.0
Medical Insurance and Coding 4.0
Records Management and Database Grade 4.0
High School Graduate Kellam High 1994
Member of the National Honors Society Phi Theta Kappa
SKILLS
Medical Office Management and Administration/ Administrative Office Support
Customer Service
Medical Terminology
Microsoft Word and Excel programs
Insurance Verification and Pre-Auth for Insurance Approval
Data Entry, Data Base
Reconciling and Rebilling claims back to insurances via UB04 and 1500s
Patricia Motley
CONTACT
577 Akron Ave.
Chesapeake, VA 23322
************@*****.***
Experience
For 15 years I worked at the largest healthcare provider in Virginia as the Lead Reporting Agent for the Centers of Medicare and Medicaid reviewing over 15,000 accounts to report back to the Federal and State Government every quarter.
As a Senior Account Analyst and Auditor Specialist I lead a team that would analyze upwards of 50,000 accounts, looking for overpayment discrepancies in charges and payments based off of Nurse Audit Charge Reports, EOBs and Remits converted from EOBs that assisted in reconciling accounts.
As a leader I trained Supervisors and new co-workers in my division on how to analyze the accounts and how to quantify the accounts into reports for further data analyst.
Communication
While I was at Sentara Healthcare, I received awards for exceptional communication regarding patient education on coordination of medical benefits with Medicare and other major insurances or benefit programs. This way patients could maximize their own personal health and self-care treatment plans with their physicians and medical teams. I also diligently worked with other agents and representatives to ensure accurate refunds of overpayments, collection of underpayments, or corrective billing to resolve discrepancies.
PRIOR CERTIFICATIONS
Medicare CMS 2007-2021
Medicaid CMS 2007-2021
References
Dr. Charles Curran, Anesthesiologist 757-***-****
Robin Banks Senior Credit Analyst for Sentara Healthcare
Elizabeth Peirsons 757-***-****
ABOUT ME
I am
.
My name is Patricia Motley I am 50 years old and for 15 years I worked with the largest Healthcare Corporation in Virginia as an Account Auditor and Analyst and as the Lead Reporting Agent for CMS Medicare and Medicaid(s). As the reporting agent I was required to filed quarterly credit reports to the Federal and State advising on the discriminations on paid accounts. During my 15 years I audited over 15,000 accounts quarterly and lead a small team that audited and analyzed over 50,000 collectively. After analyzing all the accounts corrected claims were often pulled and attached with documentation and submitted back to Medicare and Medicaid then a main credit balance log would be faxed and mailed to CMS for every separate NPI that was being submitted which consisted of around 30 NPIs. Subsequently this process was completed knowing that new processes were often needed to be implemented to assist in streamlining the daunting quarterly task. Simultaneously I assisted in quantifying this data on to excel spreadsheets to show management were typical problems were located. In addition, with the task of Auditing accounts I also trained managers and co-workers on how to correctly audit an account using multiple methods to ensure accuracy typically using EOBs, Nurse Audit Reports, and Charge Reports, along with teaching how to identify why a line-item denial(s) maybe present on a claim which can cause a host of issues.
With the largest portion of the United States population going into Medicare and for many using State Medicaid to assist in secondary payments it is crucial to get all Benefits and Insurance plans coordinated correctly to improve accuracy in claims processing in a timely manner. Sadly, it takes hospital billing specialists to contact our patients to assist in educating them on what works best for them with what they currently have as this should often be done by an insurance benefit coordinator who could easily inform a patient when they are overly insured or what they have in CMS system is not properly aligned to maximize their intended healthcare needs. This is something I have found to be very interesting and exciting and often rewarding to do with assisting with our seniors.
Furthermore, at this time I do not require medical coverage from my employer or equipment to work on as I am able to provide my own. I am very strict on HIPPA Rules and Regulations and a work laptop or desktop is strictly for work and used for nothing else. I also use a VPN thru my internet provider which is Verizon this is to secure my internet and communications. I am a fast learner when it comes to new things and experiences. I am proficient in word and excel programs. I truly look forward to hearing from you soon.
Patricia Motley
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