Quality Assurance Analyst Resume Washington, DC - Hire IT People

SUMMARY:

Health Care Professional as a Medical Biller & Coder / Quality Assurance Analyst with 15 years of Experience in Health Care Insurance Billing. Proficient Auditor / Billing Specialist for Healthcare Claims, Data Information, Inpatient / Outpatient Health Insurance Claims, Utilize / Itemized Billing & Coding, Account Payable/ Receivables with Medicaid / Medicare Billing. I am seeking an Opportunity to Grow with an Organization where I can contribute to the Benefit of the Company.

TECHNICAL SKILLS:

Medical Terminology
ICD - 9/ICD-10 CM & CPT Coding
Electronic Health Records
Third Party Revenue Cycle
Billing Insurance Auditor
Credential Analyst Auditor
Microsoft Office Suite
Client Letter/Version 2.4.3
PEGA Rules/Version 6.2
Facets Medical/Dental
CareFirst Document Writer
Citrix Remote Access
Net Document/ Cerner System
Encoder Coding / Medisoft System
NextGen / Data Dimension
Condor/ Script Pro/ CHCS System
Medicaid Health Finance System
Skype For Business System

PROFESSIONAL EXPERIENCE:

Confidential, Washington, DC

Quality Assurance Analyst

Responsibilities:

Audit Contracts for CareFirst Benefits Enrollment in an Established Timeframe
Audit CareFirst Internal Name in CareFirst Document Writer for Errors
Audit Data Analysis for Client Letter / CareFirst Document Writer

Confidential, Washington, DC

Billing Payment Poster for Medicaid

Responsibilities:

Post Medicaid Insurance Payments for Mental Health Patients
Post Medicaid Insurance Bills into Department of Health Finances
Audit Payments for Medicaid Health Insurances within 1 year for Non-Payment

Confidential, Washington, DC

Data Entry Research Assistant

Responsibilities:

Enter Researched Data in a Commercial Real Estate Website Apartments.com
Update Real Estate Website with current Vacancies for Renter seekers
Follow up with Property Managers for Move In availability
Call Center Representative for Commercial Real Estate Properties

Confidential, College Park, MD

Data Entry Billing Specialist

Responsibilities:

Enter/ Verify HCFA, UB, Super Bill Claims in Citrix Software System
Enter Billing Claims from Hospitals, Doctors Offices, Ambulance Companies
Audit HCFA/UB Bills before Claims are sent to Healthcare Insurance Companies
Bill Inpatient/Outpatient, Medicare/ Medicaid, Workman’s Compensation Insurance
Enter/Scan Account Receivables/Account Payables Bills
Batch Claims Daily for Health Care Insurance Billing

Confidential, Columbia, MD

Statewide Medical Assistance Coordinator

Responsibilities:

Healthcare Liaison for the State of Maryland Incarcerated Inmates who are Terminally ill
Enter Radiology results daily into Electronic Health Records for Inmates Clinical Report
Follow up weekly with Medicaid Case Managers for Updates/Status on Inmates Application
Prepare Medical Assistance Applications attached with Itemized Bills/ Discharge Summary
Audit Healthcare Professionals for Expired License in Correctional Healthcare

Confidential, Washington, D.C

Department of Financial Counseling

Responsibilities:

Screened Registration Applications to verify individuals who may qualify for DC Medicaid, MD Medicaid, or Charity Assistance
Update Status to Department of Human Services Database for Qualified Applicants
Prepare Medical Assistance Applications for Department of Human Services with Patients Documents

Confidential, Washington, D.C

Pharmacy Technician

Responsibilities:

Process Accounts Receivable for Patients Copayment
Enter Prescriptions/Bill Insurance for Partial Payments
Contact Case Workers for Patients Refill/Pick up of Medication

Confidential, Bethesda, MD

Pharmacy Technician

Responsibilities:

Retrieved, Edit, Scanned Prescriptions in CHCS System
Mixed, Package, Label, Pharmacy Medications
Provided Customer Service to Active Duty, Military Dependents /Wounded Soldiers

Confidential, Suitland, MD

Pharmacy Technician

Responsibilities:

Enter Paper Prescriptions into CHCS System to Bill Tricare Health Insurance for Non - Active Duty
Consult Patients on how to take Medications
Packaged Monthly Supplies for Active Duty Soldiers Overseas

Confidential, Arlington, VA

Pharmacy Technician

Responsibilities:

Process Account Payable into Patients Profile for Health Insurance Copayments
Contact Physicians Office upon Prior Authorizations for Medication Payment Rejections
Entered Data for Prescriptions onto Spreadsheet
Process Health Insurance Information into Condor System

We provide IT Staff Augmentation Services!

Quality Assurance Analyst Resume

Washington, DC

We'd love your feedback!

Resume Categories

Client Services

Job Seekers

Visa Sponsorship