Customer Service / Data Entry / Medical Coder

Lynnette Medina 130 Malibu Drive                                                                               Fayetteville GA, 30214                                                              Louise90nana@yahoo.com                                                   (770) 770-742-0598 or  (518) 488-2262
Objective:  To obtain a position utilizing my extensive office skills. 
HIGHLIGHTS OF QUALIFICATIONS 
Works effectively with public, Excellent interpersonal and team building skills, Excellent verbal and written skills, Quick at learning, Enjoys a challenge, Reliable, Responsible with attention to detail, Strong PC skills and Microsoft Windows. Working knowledge with on-line claims processing, Strong problem resolution & Years of experience in customer service.
Work Experience:         
CDPHP:  Albany, NY 2002-2013 Provider Support Specialist
Responsible for in coming and out going calls.  Handle department of insurance issue. Handle appeals & correspondence by Telephone, Mail, Email or Fax. Send letters to provider’s. Give out benefits for Health Insurance including but not limited to Dental, Vision & Mental Health /Substance Abuse.  Handle all lines of business including but not limited to Health Funding Accounts HMO, EPO, High  Deductible plans, Healthy New York,  Manage care plans such as Medicare, Medicaid, Family Health Plus & Child Health Plus, HRA Accounts. Coordinate benefits with other Insurances Companies including but not limited to Workers Compensation & No Fault insurance.  Help provider and Member’s with Health Web-online service.  Interpret all CDPHP health plan contract language, riders, schedules, policies and procedures with adherence to department turnaround timeframes to insure regulatory compliance
*    Meet established quality and production standards while maintaining department turn around.   *    Created and wrote policies.  *    Completed the Magic Training program. *    Trained new employees & refresh seasoned Specialist.  *    Received 74 Star awards from External & Internal customers for excellence. *    Received 82 Pickles from my peers for being a team player. *    Was chosen as the face of CDPHP on the internet  (WWW.CDPHP.COM)
Albany Medical College:  Albany, NY 2001-2002 Claims Analyst
Responsible for AR follow up with multiple insurance companies. Sending letters, Appeal’s & other correspondence for Claims to get paid at 100%.  Notify Patient’s of balance on invoices. Receive and make calls concerning accounts.  Email, Fax, Photo copy, Scan Correspondence & Post Denials / Adjustments.  
*    Work in 90  days & over group with large cash amounts. *    Create policies for employee’s.   *    Meet daily goals.
Empire Health Choice:  Albany, NY 1998-2001 Claims Examiner & Data Entry Operator Responsible for entering health claims into the system.  Sending letters to Member’s / Provider’s
Coding- Strong ICD9, CPT4 & HCPC’S. Handled Confidential accounts. Enter health claims into system Provider coding. Medical terminology. Correct scanned forms in order for them to be paid correct.  
*    Worked on different systems Medical, Institutional, ICR /OCR FEPR & OEC *    Worked proficient with minimal supervision *    Keyed claims from Image . *    Submitted 2 star quality ideals  *    Met daily benchmarks based on a 7.5 hour workday
Key Bank:  Albany, NY 1996-1998 Bank Teller
Responsible for handling/advising customers on all banking needs.  Meeting & Greeting customers.  Handled small to large amounts of money, credit/debit account, handled foreign currency.  Advised customers on certain loans/investments that may meet their financial needs.  Filing, Fax.  Handled Multiple telephone lines.
*    Meet monthly quotas. *    Sold many of the products Key Bank offered. *    Trained New Employees.
Education:
Mildred Elley College for Careers Graduate
Reference available upon request 

  • ID#: 73659
  • Location: Fayetteville, GA , 30214

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