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@ToshiyaLuckey
Flag of United States Richardson, United States
Member since September, 2012
0 Recommendations

ToshiyaLuckey 

I have been in the Medical Industry for 13 years, which included a massive amount of Data Entry as well as the meeting of major deadlines and reports. I believe in doing things right the very first time and giving each project my undivided attention. What I can and will do for you and your company is Deliver Accurate Reports in a timely fashion.
$7 USD/hr
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Experience

Quality Assurance/Reporting Analyst II - Trainer

Feb 2011 - Jan 2012 (11 months)

Complete high level reports and audits to ensure company is running properly daily. Provide management with daily volume of claims and statements extracted from TES to Bar, including categorization, and daily monetary cash balances. Provide and participate in performance training of employees. Recommend employee improvements, write step by step Policy & Procedures for selected departments, provide employee coaching, and report errors to supervisors weekly. Perform daily analysis ensuring all elect

Claims Examiner/Customer Service Rep

Jan 2009 - Jan 2011 (2 years)

Verify, key, and process submitted Medicaid, CHIP Perinate, and Physical Therapy UB92 and HCFA claims according current and relevant State Rules and Regulations. Exceed production averages and accuracy minimums for payments and denials. Communicate with providers and members through clear and concise correspondence. Monitor and follow up on pending claim activity requiring additional information timely and accurately. Take inbound member, client, and broker calls. Enforce HIPPA laws with each p

Various Contract Positions

Apr 2008 - Dec 2008 (8 months)

Kelly Services (Cigna) - April 08 - July 08 - Claims Examiner Verify, key, and audit Workers Compensations claims for all 50 states based on Rules and Regulations. Determine that each incident is a work related prior to payment or denial. Correspond with providers via telephone and written/automated generated letters as needed. Maintain speed, accuracy, and turnaround time. Progressive Staffing (Ameripath) - August 08 - August 08 - Data Entry Operator Accurately key laboratory bills in a producti

Claims Examiner/Trainer

Oct 2007 - Mar 2008 (5 months)

Verify, key, and audit all incoming claims based on the State of Texas Workers Compensation Rules and Regulations. Correspond with providers via telephone or mail regarding payments and denials. Process specialty claims and accounts. Train, audit, and coach incoming employees. Maintain all accuracy guidelines set by management, meet all deadlines, and turnaround times.

Claims Examiner

Jan 2005 - Jul 2007 (2 years)

Verify, key, and audit Workers Compensation Claims for according to TX/ FL Rules and Regulations. Determine that each claim is in response to a true work related incident Contact providers as needed via telephone or written correspondence. Train, audit, and coach incoming employees. Maintain speed, accuracy, and turnaround time on each claim.

My Top Skills

  • Data Processing 0
  • Data Entry 0
  • Research 0
  • Excel 0
  • Customer Support 0
  • Powerpoint 0
  • Oracle 0
  • Microsoft Access 0
  • Cisco 0
  • Sharepoint 0
  • Electronic Forms 0
  • Contracts 0
  • Phone Support 0
  • Order Processing 0
  • Microsoft 0
  • Audit 0
  • Copy Typing 0
  • Lotus Notes 0
  • eLearning 0
  • OCR 0

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