Natalie Davis - Resume v4
Published on: Mar 3, 2016
Transcripts - Natalie Davis - Resume v4
NATALIE DAVIS (718) 749-4527
LinkedIn Profile: https://www.linkedin.com/pub/natalie-davis/2a/483/98b
Over 10 years of customer service and healthcare billing experience. I am a diligent self-starter, willing to
assist in many areas of the unit. Recognized for ability to work in a high-volume and deadline-orientated
environment. The ability to work as part of a team, as well as work independently with minimal supervision is
one of my strengths. Demonstrated ability to absorb, retain and effectively utilize a wide range of
information regarding policies and procedures. Maintains strictest confidentiality; adheres to all rules and
regulations; experienced in relaying sensitive information.
Associates Degree in Humanities and Social Sciences 2003
Nassau Community College – Garden City, NY
• Strong Attention to Detail
• Conflict Resolution Skills
• Detailed Recordkeeping
• Customer Service Oriented
• Research, Writing and Organizational Skills
• Confidential and HIPAA Compliant
• End Stage Renal Disease (ESRD) Specialist
• Expertise in Dialysis Medicare System Applications:
Coordination of Benefits (COB) and REMIS
• Proficient in Microsoft Word, Excel, Outlook, ISSI,
DocuWare, and EncoderPro
Medical Claims Processor and Customer Service Representative January 2014 - Present
Local 1102 RWDSU
Responsiblefor receiving, analyzing and adjudicating medical and institutional claims.
Profound knowledge of codes applicable in CPT, HCPC, Revenue and ICD-9 systems.
Complete understanding of all eligibility verification processes and COB.
Processed claim forms, adjudicates for provision of deductibles, co-pays, co-insurance maximums and
Compile all medical records needed for staff physician review to determine approval.
Analyze and reconcile total payouts regarding subrogation.
Authorized to process facility claims payouts up to $100,000.
Provide timely customer service to members, providers, and other insurance companies on the subject of
Resolve related issues to claim adjudication and queries as received.
Customer Service Representative January 2007 – April 2013
Emblemhealth Medicare Coordination of Benefits – New York, NY
Provided health insurance customers with professional service and assistance in specialized unit; quickly learned and excelled in
using Medicare system applications, such as Renal Management Information Systems (REMIS).
Answered incoming calls and provided customer service relating to Medicare; updated customers’ records
promptly and efficiently.
Met departmental goals for production and accuracy; maintained daily standards for call quality, length
Demonstrated problem solving and active listening skills; diffused difficult customer issues with tact and
Maintained cooperative and positive working relationships with department personnel, beneficiaries,
providers, attorneys and Medicare departments.
Trained and coordinated other staff on End Stage Renal Disease (ESRD) procedures.
Successfully completed all specialprojects assigned by supervisor or manager.
Medical Biller July 2004 – January 2007
Clinical Practice Billing at Winthrop University Hospital – Mineola , NY
Billing functions for the Cardiovascular, Thoracic Surgery & Critical Care Intensive units. Handled data provided by the
medical coders and used it to compile/submit claimsto insurance companiesand then subsequently bill patients.
Collected, posted and managed account payments; responsible for submitting claims and following up
with insurance companies.
Handled information about patient treatment, diagnosis and related procedures to ensure proper coding.
Responsible for all rejections, denials, appeals and edits for commercial carriers.
Handled monthly reconciliation for the entire department; oversaw daily Medicare tape remittance
Resolved customer inquiries, complaints and billing questions.
Ensured daily entry and reconciliation of payments; monitored third party payment activities.
Reported internal inconsistencies and provided weekly statusreports to manager.