More than Just Lines on a Map: Best Practices for U.S Bike Routes
Ericka Littlejohn Resume 2016
1. Ericka Littlejohn
5728 Swords Dr.
Fort Worth, TX 76137
Email: littlejohn.ericka@yahoo.com
Cell: (773) 703-1796
Objective
A responsible,dedicated,formally trained and committed Professional seekingto join a growingorganization to
increasecorporatebottom line. A meticulous professional who has firmgrasp of this industry.
Skills
● TruCare/WebCM/ CRM/Amisys/ECCPIS Proficient
● HIPAA Certified
● Oracle/Integrimatch/SAPProficient
● CPT, ICD-9-CM, HCPS Coding proficient
● Anatomy, Physiology, and Medical Terminology Proficient
● Claimsgear and Medisoft BillingSystemandEOB resolutionproficient
● Skilled Microsoft Word, Outlook, and Excel
● Windows XPandVista
● Data Entry, Alpha Numeric typing and Filing/8000/KSPH/60 WPM
Education
AssociatesDegree 2010 Medical Insurance Billing& Coding
2. Experience
Centene-Westmont,IL 11/2014-Current
ProgramCoordinatorI (IllinicareHealth)
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 potentialsystemproblems and claims training issues.
Prepare and Initiate Inpatient and outpatient authorizations
Attend departmentaltraining 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 thereview of various claims reports and perform other health administrative duties.
Referral SpecialistI (Illinicare Health)
Processing of outpatient waiver and some inpatient authorizations listedwithinTruCare system.
Keep up withupdatesandchanges in policyandprocedures as well as being able to adapt andlearnsystemuse for
CRM, Amisys, WebCMandTrucare.
Timelycompletion and accurate data entryof allhome basedservicestask.
Research, correct or update anyauthorizations that showup onanyerror report receivedfromclaims.
Attend training andcompliance sessions as scheduled.
Complete custodial auths for LTCmembers, which includesclosing, opening, or discharging authorizations whena
member leaves or returns to a nursing home.
Monthlymaintenance of termedmember spreadsheets.
Work on special projects assignedbysupervisor
Various other duties
Medix-Chicago,IL 3/2014-7/2014
MedicaidCashPoster (Season’sHospice)
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, prepareinvoices for hospice patients to be processed for payments and preparespreadsheets for
payments.
Help prepareand organize payments and checks to be mailed to nursing homes for hospice services
Have worked in billing/review department.
3. Randstad-Chicago,IL 12/2012-3/2014
AffordableCareAct EnrollmentSpecialist(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 thephone 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.
MedicaidEligibiltySpecialist(Maximus)
Review redetermination cases sent by the client through work queues assigned by the Eligibility Supervisor.
Evaluating data provided by theverification system against State eligibility requirements Review documentation sent in
by clients to make accurate determinations on whether theclient 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.
Makerecommendation and determinations on Medicaid coverage for clients
ClubAssist-Chicago,IL. 10/2012-6/2013
Data Entry/AccountsReceivables
Manage financial ofautoparts soldandreceived
Enter CashReceipts
Manage Invoice Records andrecord all revenue paid and owed
Prepare and manage spreadsheets of revenue records
Chiro One Wellness Centers-OakBrook,IL. 01/2011-07/2012
Data Entry/CashReceipt Specialist
Reconcile bankaccount statements
Manage financial using QuickBooks accounting program
Verifying Debits andCredits postedto accounts
Followthroughontimelyand accurate month-endclosings
Create financial reports to showstatistics, such as cashreceipts, accounts payable andreceivables, etc.
Enter cashreceipts, charge-backs andrefunds
Checkedbalances in general ledgers
Balance dailytotals to systemandprepare bankdeposits
Record EFT payments andnotifyclinics ofreceipt
Various other accounting functions