Fatima Harris Email & Phone Number

Charlotte, NC, US

United States

• Competent in insurance guidelines and staying abreast of changes that occur.
• Work independently in a fast-paced remote environment with limited supervision.
• Communicate with Providers related to coding issues that are of mid to intermediate complexities. (Ex: anesthesia time, Modifiers, Non-covered services, Medical Necessity, service limits).
• Provide personalized support to Members by navigating them through complex billing issues which contributes to a better customer experience.
• Review & store clinical documentation needed for medical necessity for our Clinical Team.
• Prioritize my workload to continuously answer incoming calls and main established schedules with limited supervision.

Remote

• Manage Service Members medical benefits for the Tricare East Region.
• Advise Provider’s Medical Necessity that is required for claims to be reviewed and reprocessed according to Plan Guidelines.
• Prioritize my workload to continuously answer incoming calls and main established schedules with limited supervision.
• Educate Veterans and Beneficiaries on charges, denial reasons and appeals processes.
• Perform CPT/HCPCS/DX code checks to determine if Referrals and Pre-Certifications are required for service members and their families.
• Meet Monthly Phone Metrics: 93% compliance, 95% call quality and 92% availability.

Columbia, South Carolina, United States

• Work alongside internal departments and stakeholders to issue and transmit requested documents for training purposes.
• Organize and maintain an average of 45 documents daily, adhering to the company's document lifecycle procedures, and archive inactive records in accordance with the records retention schedule.
• Assist with other administrative tasks as needed.
• Train internal departments on proper document handling and management processes.

Columbia, South Carolina, United States

• Complying with federal, states, and company regulations and policies.
• Reviewed claims and payments for accuracy and adherence to correct coding and billing standards as outlined by the organization.
• Respond to incoming calls while processing applicable transactions during calls and created work items in Automatic Workflow (AWF).
• Accurately process insurance claims in a timely manner while providing superior customer service.
• Analyzed and researched complex healthcare claims to identify discrepancies: verify pricing, confirm prior authorizations, referrals, and process payment for clients.
• Gather & report data state guidelines.

Sumter, South Carolina, United States

• Follow the Plan of Care as indicated on the Aide Activity Sheet.
• Assist residents with personal care which included: bathing, mouth care, denture care, skin care, grooming, transferring, ambulation, dressing, and undressing.
• Assist residents with light housekeeping, preparing meals, feeding, laundering clothes and bedding.
• Attend Orientation Training and Service Specific Training required by State Law.
• Monitor and record basic vitals.
• Communicate any noticeable changes to the patient’s health to medical personnel.

Syracuse, New York, United States

Complete adequate and necessary documentation during the shift, including reading and signing all necessary documentation, thoroughly and on time.Bed checks at time specified on IPOP.Medication Administration Assist in creating a safe and secure environment, including securing objects that may be dangerous, maintaining cleanliness, ensuring safety of.

Syracuse, New York, United States

• Review MARs (Medication Administration Records) and discuss current medications and changes with Charge nurse.
• Log incoming medication deliveries for the month in MARs.
• Store and lock Narc medications for the safety of residents and staff.
• Prepare proper dosages and distribute medications to residents.
• Document all medication taken to ensure patient records are current.
• Performed room checks for all residents.

Master Of Science - Ms, Health/Health Care Administration/Management, 3.6

Bachelor Of Science (B.S.), Health Services/Allied Health/Health Sciences, General

Associate Of Arts And Sciences (A.A.S.), Liberal Arts And Sciences/Liberal Studies