NATALIE DAVIS (718) 749-4527
LinkedIn Profile:
 Demonstrated problem solving and active listening skills; diffused difficult customer issues with tact and
 Maint...
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Natalie Davis - Resume v4

Published on: Mar 3, 2016

Transcripts - Natalie Davis - Resume v4

  • 1. NATALIE DAVIS (718) 749-4527 LinkedIn Profile: PROFESSIONAL SUMMARY 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. EDUCATION Associates Degree in Humanities and Social Sciences 2003 Nassau Community College – Garden City, NY SKILLS SUMMARY • 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 EXPERIENCE 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 provider disbursements.  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 claims.  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 and quantity.
  • 2.  Demonstrated problem solving and active listening skills; diffused difficult customer issues with tact and ease.  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 reconciliation.  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.

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