Data Entry Part-Time

LILLY W. SINFEYA

**** ********* ***** **********, ** 27407 336-***-**** *******@*****.***

SUMMARY OF SKILLS

Excellent multi-tasker and team player with a positive attitude.

Skilled in exercising independent judgement and leading through change

Versed and trained in basic billing and coding languages to include CPT, ICD-9 and ICD-10

Highly effective Denial specialist in preparing necessary documentation to submit complex reconsiderations/appeals

Demonstrates critical thinking, improvement meters and problem solving to resolve complex denials & revenue issues

Worked on all major payer plans (Uhc mcr, Aetna mcr, Cigna mcr, Humana mcr, Wellcare mcr, Managed Care and various other generic plans

Strong communicator with ability to work across the board with internal and external customers to obtain information for resolution of complex denial trends

Excellent oral and written communication skills, with excellent attention to detail and time management skills

Skilled in updating information into database systems

Critical thinking skills used to find root cause of complex denials and issues

Collaborate with appropriate departments for improvement opportunities

Compliant with HIPAA, government regulations and guidelines

EDUCATION

1/13 – 5/15

Guilford Tech. Comm. College

Greensboro, NC

A.A.S. Degree, Healthcare Management Technology

Certificate, Medical Office Administration

Certificate, Electronic Medical Records

Certificate, Medical Office Billing and Coding (July 2015)

Cumulative GPA: 3.8 / Honor’s List & Dean’s List

Member of PHI THETA KAPPA HONOR SOCIETY

WORK EXPERIENCE

8/15-Present Wake Forest Baptist Medical Center Winston Salem, NC

Patient Accounts Coordinator/Denial Specialist/Electronic Medical Record coordinator

Work with Patient Financial Services (PFS) in Denials dept, responsible for reporting, monitoring, analysis, and follow-up of denials. Resulting in which a denial of payment has been received from a payer. Identify when a denial should be appealed or if a write-off is needed. Provide appropriate denial information to root cause areas to ensure systems, processes and measures of effectiveness are created and implemented to reduce or eliminate denials. Perform extensive follow-up, complete appeals, and make referrals to other stakeholders. Use all appropriate systems to effectively research claims and complete steps to submit information necessary to process or appeal claims. Completes follow-up with patients when needed. Prepare necessary documentation to submit appeals to payers when payment is delayed or denied. Rebill or reprint claims as necessary and appropriate. Complete and request adjustments to a claim, based on the dollar threshold of the adjustment. Review, work, and report all claims that have aged more than the specified grace period stipulated in the policies or contracts. Track and report violation of prompt pay by payers and follows up proactively with payers to provide necessary additional documentation for patient claims that have been reviewed by payers and are awaiting documentation to determine adjudication. Document the patient accounts appropriately. Update claims with appropriation transactions to reflect current collection status. Report issues and trends to appropriate PFS management personnel and work collaboratively to develop solutions. Organize work to meet deadlines. Participate in all educational activities. Perform specialized duties for the team and assist management with daily activities. Maintains a thorough knowledge of tasks performed in the department to fulfill the task of the other team members in their absence.

9/00-9/12 AVERY DENNISON Greensboro, NC

Lead Batcher for VIPS / Asst. Supervisor

Worked for the Data Management Dept. entering customer orders into multiple software systems in preparation for production (e.g. Used Oracle, TRIM, and Tagis II)

Performed daily system checks which required file reorganization and accurate records management Performed on-going quality checks of the Dept.’s hard/electronic record systems

Monitored the performance of output for Batching program and assigned workflow accordingly

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