Administrative, Clerical, Recptionist, Customer Service

Traci Andrea Harvey

Cell Phone: 803-363-8089 / Phone: 803-834-4780

1000 Windsor Shores Drive, 23C, Columbia, SC, 29223



Professional Profile:

* Administrative professional with over 15 years of experience
working in fast-paced environments

    * HEDIS Project background

      * Strong organizational and interpersonal skills

        * Detail-oriented with a unique ability to manage multiple
        secretarial tasks

          * Highly trustworthy, ethical and discreet; committed to
          superior customer service

             

            Professional Experience:

             

            WellCare Health Plans, Inc. - Columbia, SC  February 2015 to May 2015

            QI Coordinator (Contract)


            * HEDIS PROJECT (Medical records management)

              * Handled telephone inquiries for provider participation in claims  updates with the OHIS system

                * Special projects as assigned or directed

                  Stay at home mom - May 2014  -  March 2015

                  WellCare Health Plans, Inc. - Columbia, SC  March 2014 – May 2014 

                  QI Coordinator (Contract)


                  * HEDIS PROJECT (Medical records management)

                  * Handled telephone inquiries for provider participation in claims  updates with the ALTEGRA system

                  * Special projects as assigned or directed

                   

                  AMCOL SYSTEMS - Columbia, SC   June 2012 – October 2013           

                  Production Support Specialist (Call Center/Administrative) 


                  * Processed all inventory in assigned work queues

                  * Searched for location of Explanation of Benefits or payer remittances for review of
                  information or billing purposes

                  * Achieved daily, weekly and monthly assigned production goals to include accounts worked,
                  correspondence pending and multiple related reports assigned

                  * Received and process all FACS mail corresponding to assigned inventory

                  * Completed user defined windows in accordance with company policies and procedures

                  * Interacted with Business Office personnel to resolve difficult claims and to report issues
                  that are creating backlogs in the work queues that need immediate resolution

                  * Represented the company in a positive manner through professional conduct, attitude and
                  appearance

                  * Followed company Confidentiality and Security policies and procedures

                  * Performed other duties as assigned 

                    COLUMBIA NORTHEAST KIDNEY CENTER - Columbia, SC  March 2010 – February 2012 

                    Administrative Assistant

                    * Answered incoming calls, greeted patients and vendors as they entered the clinic

                      * Keyed in billing data into the QMS system

                      * Prepared patient’s lab requisitions and blood tubes

                      * Audited and maintained personnel files

                      * Maintained patient’s medical records and ensured the confidentiality of patient medical
                      records according to HIPAA regulations

                      * Assisted patients as needed

                       

                      BLUE RANGE PHYSICIANS MANAGEMENT – El Paso, TX  September 2009 -December 2009     

                      Patient Account Services Coordinator

                      * Submitted both soft and hard copy claims to various insurance companies

                      * Ensured the accuracy of all patient data on the claims, including ICD-9, CPT-4, and
                      HCPCS codes

                      * Reprocessed and appealed all incorrect claims on a daily basis

                      * Contacted patients with outstanding balances and assisted them in making financial
                      payment arrangements

                      * Accurately posted insurance, patient payments, and balance transactions daily 

                       

                      PMAB LLC - Charlotte, NC April 2008 – February 2009      

                      Patient Financial Representative

                      * Verified hospitalization insurance coverage by internet, updated patient benefits,
                      demographics, and compiled itemized statements for hospital billing

                      * Contacted
                      insurance companies to verify the patient’s coverage to obtain information
                      concerning the extent of their benefits

                      * Assisted patients in resolving their account balances by offering discounts, payment
                      plans, and payment schedules

                       

                      CAROLINA HOSPITAL SYSTEM - Florence, SC  February 2004 -February 2007 

                      Administrative Assistant 

                      * Answered  telephones and transferred calls to appropriate staff members of the Medical
                      Records Department

                      * Sorted and distributed all physician medical reports and documents

                      * Performed general clerical duties, including photocopying, faxing, mailing, and filing

                      * Created and modified documents using Microsoft Office and Word

                      * Released medical information to various hospitals and doctor’s offices

                      * Ordered office supplies for the Medical Records Department

                       

                      CAROLINA HOSPITAL SYSTEM - Florence, SC  June 1999 – October 2003         

                      Medical Coder 

                      * Reviewed medical record charts for accuracy and completion

                      * Entered all supplemental orders into the tracking system for the Home Health and
                      Hospice Department

                      * Verified medical data in the computer and filed 485 admission forms upon completion

                      * Clarified information or the diagnosis by communicating with Nurses, Social Workers, and
                      Physical Therapists 

                       

                      BLUE CROSS AND BLUE SHIELD - Florence SC  August 1998 – May 1999

                      Insurance Claims Representative  

                      * Applied accurate CPT-4 and ICD-9 coding, while entering information into the computer
                      database

                      * Performed necessary research for clarification of correct diagnosis or procedures on the
                      claim

                        * Performed control development by telephone or in writing to secure all information for
                        processing of the claim

                          • ID#: 89573
                          • Location: Columbia, SC , 29223

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