Coordinator

KENYA MAYFIELD

**** * ***** ***** ***** Chicago IL, 60649 773-***-****

*************@*****.***

OBJECTIVE

To obtain secure employment with an organization that fosters professional growth, encourages a balanced work environment and allows optimal utilization of customer service skills acquired through work experience in the public sector.

SKILLS SUMMARY

Customer Service Focus ALLEGRA SYSTEM

Microsoft Office 2000 TPA (Third Party Administrator)

CE2000 (Insurance Database System) Detailed Orientated

STARS (Insurance Database System) Ability to work independently

NEBO SYSTEM Medical Terminology/ICD-9 Coding

NDAS SYSTEM Team Orientated

PROFESSIONAL EXPRIENCE

CAREMARK INC May 2006-October 2007

Admissions/Patient Care Coordinator

Responsible for validating the demographic, conducting benefits research and reimbursement information on all health care plans prior to the initiation of therapy. Adjudicate pos/mail order billings and relate financial obligations to the customer. Verify HMO, PPO, Medicare and Medicaid insurances via phone and internet system. Process claims for the specialty medication for multiple insurance carries via electronic and manual systems. Obtain prior authorization when necessary. Address customer inquiries and identify issues/problems and escalate for resolution.

INGALLS MEMORIAL HOSPITAL April 2002-January 2006

Customer Associate

Generate and establish appointments for inpatient and outpatient visits. Work in conjunction with clinical test departments for first available opening. Interview the patients to obtain demographic, insurance and financial data. Enter accurate registration and clinical data in computerized systems. Communicate with physicians and or office staff to coordinate required orders, referrals, prior approvals and diagnosis. Perform eligibility and benefit verification via electronic system. Merge inpatient stay accounts and process inpatient/outpatient surgical procedure referrals for billing purposes.

EDUCATION

Associate Degree in Electronics Engineering Technology, ITT Technical Institute 2002

Southern Illinois University

References upon request

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