Ericka Littlejohn Resume 2016

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<p>Top of FormErickaLittlejohn</p> <p>5728 Swords Dr.</p> <p>Fort Worth, TX 76137</p> <p></p> <p>Cell: (773) 703-1796</p> <p>Objective</p> <p>Aresponsible,dedicated,formally trainedandcommittedProfessional seeking to join a growing organization to increase corporate bottom line. Ameticulousprofessional who has firm grasp of this industry.</p> <p>Skills</p> <p>TruCare/WebCM/CRM/Amisys/ECCPISProficient</p> <p>HIPAACertified</p> <p>Oracle/Integrimatch/SAPProficient</p> <p>CPT,ICD-9-CM,HCPS Codingproficient</p> <p>Anatomy,Physiology, andMedical TerminologyProficient</p> <p>Claimsgear and Medisoft Billing System and EOB resolution proficient</p> <p>SkilledMicrosoft Word,Outlook, andExcel</p> <p>Windows XP and Vista</p> <p>Data Entry,Alpha Numeric typingandFiling/8000/KSPH/60WPM</p> <p>Education</p> <p>Associates Degree2010Medical Insurance Billing &amp; Coding</p> <p>Experience</p> <p>Centene-Westmont, IL 11/2014-CurrentProgram CoordinatorI (Illinicare Health) Proficiently review claims for completeness and approve/deny pending claims for payment using established guidelines. Document clearly and concisely claims adjudication decisions in Claim Notes. Identify potential system problems and claims training issues. Prepare and Initiate Inpatient and outpatient authorizations Attend departmental training when required. Perform and conduct research on claims inquiries and reprocess claims. Perform effective research on larger projects and major reconciliations. Monitor and determine claims accuracy using available claims editing tools. Assist supervisor in the review of various claims reports and perform other health administrative duties.Referral Specialist I (Illinicare Health) Processing of outpatient waiver and some inpatient authorizations listed within TruCare system. Keep up with updates and changes in policy and procedures as well as being able to adapt and learn system use for CRM, Amisys, WebCM and Trucare. Timely completion and accurate data entry of all home based services task. Research, correct or update any authorizations that show up on any error report received from claims. Attend training and compliance sessions as scheduled. Complete custodial auths for LTC members, which includes closing, opening, or discharging authorizations when a member leaves or returns to a nursing home. Monthly maintenance of termed member spreadsheets. Work on special projects assigned by supervisor Various other dutiesMedix-Chicago, IL 3/2014-7/2014Medicaid Cash Poster (Seasons Hospice) Medicaid Payment duties include posting payments, adjustments, denials and rejections for manual Medicaid electronic remittance to the correct client/patient/line item, by the deadline, with accuracy for 20+ states. Verify that payment amounts and batch totals are correct before posting batches. Verify that Medicaid electronic deposits are posted at the bank. Read and analyze EOBs and research accounts in credit balance status to refund or adjust accounts. At end of month, prepare invoices for hospice patients to be processed for payments and prepare spreadsheets for payments. Help prepare and organize payments and checks to be mailed to nursing homes for hospice services Have worked in billing/review department.</p> <p>Randstad-Chicago,IL 12/2012-3/2014Affordable Care Act Enrollment Specialist (Maximus) Receiving Inbound and making Outbound calls to clients to clarify or obtain additional information regarding healthcare packages. Provided service and product information for various healthcare packages available to eligible consumers. Process enrollment for health insurance for Affordable Care Act (Obama Care). Acting as second contact to consumers and reassuring enrollments and eligibility. Resolved customers technical issues over the phone such as password reset and account lockouts. Check status of unprocessed applications and get applications processed or evaluated by insurance brokers to assure the best health plan for consumers. Medicaid Eligibilty Specialist (Maximus) Review redetermination cases sent by the client through work queues assigned by the Eligibility Supervisor. Evaluating data provided by the verification system against State eligibility requirements Review documentation sent in by clients to make accurate determinations on whether the client is still eligible for coverage or if information is conflicting and needs further review. Outbound calls to clients to clarify or obtain additional information Effectively communicate with a wide-variety of individuals on sensitive, confidential, and critical information while complying with HIPAA regulations. Make recommendation and determinations on Medicaid coverage for clients</p> <p>Club Assist-Chicago, IL. 10/2012-6/2013Data Entry/Accounts Receivables Manage financial of auto parts sold and received Enter Cash Receipts Manage Invoice Records and record all revenue paid and owed Prepare and manage spreadsheets of revenue records</p> <p>Chiro One WellnessCenters-Oak Brook, IL. 01/2011-07/2012Data Entry/Cash Receipt Specialist Reconcile bank account statements Manage financial using QuickBooks accounting program Verifying Debits and Credits posted to accounts Follow through on timely and accurate month-end closings Create financial reports to show statistics, such as cash receipts, accounts payable and receivables, etc. Enter cash receipts, charge-backs and refunds Checked balances in general ledgers Balance daily totals to system and prepare bank deposits Record EFT payments and notify clinics of receipt Various other accounting functions</p>