Data Entry Based Systems
Resume:
Andrea Frometa
Palm Harbor, Fl 34683
Computer skills
I am experienced in ORACLE based systems, UHOPS, PRIME, CIRRUS, ACET, ICUE, Knowledge Central. Continulink, Carevoyant, Haven, PC-ACE, Availity, IVANS and Intergy Billing systems as well as the DDE (direct data entry) system provided by the Ability Network. Proficient in all Word and Excel as well as MAC and PC.
Experience
United Healthcare
Oldsmar, Fl (Remote) 11/1/21 – current
PRIME EDM
Assist groups with EDI Onboarding on the PRIME and USP Platform
Load files into system and review for errors
Advise groups of errors to be corrected in order to move to production.
SME for PRIME platform
Worked with development on setting up ETPro and CIP for PRIME
Train new EDMs
United HealthCare
Oldsmar, Fl 10/17/2019 to 11/1/2021
AllSavers Claims Clerk
Process 100-200 claims daily for payment
Took provider calls
Gave benefit information
Created authorizations and provided authorization status
Provided claim status
Answered 100-150 provider calls daily
Consistently met monthly goals
United HealthCare
Oldsmar, FL 06/17/2019-10/17/2020
OXFORD Sr. Provider Resp
Answered all incoming calls through VCC
Reviewed claim status and resubmitted claims for reprocessing as needed
Provided Benefit information
Created New referrals using PULSE system
Florida Medical Clinic
Land O Lakes, Florida 2/20/2017 to 5/17/2019
Insurance Specialist
●Processed all Physical therapy claims
●worked with BCBS, Cigna, Medicare, Workers Comp and Auto and UHC Insurances
●Responsible for a 22% increase in revenue
●Responsible for decreasing a/r down to 2% revenue owed
●Processed all appeal request and denials
Horizon Home Care
Trinity, Fl 5/23/16-Current
Billing Assistant
●Processes all insurance verification and authorizations
●Answered all incoming call
●Fielded all patient questions/complaints
●Scheduled staff
●Ran meccas
●Worked daily a/r reports
●Collections on a/r reports
●Adjustments/write offs on old/uncollectable accounts
ThyssenKrupp Elevator
Tampa, Florida 1/6/2016-4/22/2016 Contact position
Payroll/Billing Auditor
●Processed payroll for 4 TKE branches
●Processed all billing reports and reviewed for accuracy
●Entered corrected payroll info into ORACLE based system
●Entered corrected billing rates into ORACLE based system
Synergy Consulting Services Inc.,
Lutz, Florida 8/2010-6/2015
Billing/Office Manager
●Processed payroll for 150+, RNs, PTs, OTs, STs, HHA and CNAs on a bi-weekly basis
●Responsible for 4-5% increase in receivables for the last 2 years consistently.
●Entered OASIS forms, put together all 485 POCs for new patients. Submitted OASIS to state and processed all reviews of OASIS validation reports and corrected as needed.
●Responsible for all annual staff reviews.
●Over saw all processes for electronic claim submission as well as 999/RSP retrieval.
●Worked directly with owners on day to day procedures
●Prepared quarterly analytical reports for review.
●Implemented policy and procedures as needed.
Advocate Home Health,
Chicago, IL 9/2007-9/2008
OASIS/Scheduling Coordinator
●Responsible for processing all SOC and DC oasis and well as all payroll for field nursing staff of 75 RN’s, PT’s, OT and ST’s.
●Scheduled all PT/SN/OT/HHA/CNA visits
●Ran all OASIS validation reports and reported findings to appropriate administrator
●Processed time sheets for all field staff
●Answered phones as needed
Interim Home Health,
Chicago, IL 11/2004-9/2007
Scheduling Coordinator
●Managed all day to day operations for Office staff
●All SN/PT/OT/HHA/CNA visits
●Weekend scheduling for skilled and private duty staffing.
●Managed all new hire paperwork and pay rate changes
●Processed payroll for all field disciplines
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