LaQondia Weaver resume
4124 Buenaview CT Nashville, TN 37218 ------------ Message Phone:------------ E-mail:------------
LAQONDIA VACHELLE WEAVER
Objective
To obtain a position in an organization that will allow the expanding of achieved skills while assisting to further enhance my performance at current job to gain work experience in clerical support with the opportunity for advancement.
Education
08/1990-05/1991 Belmont University, 2900 Belmont Boulevard Nashville, Tennessee 37212
Studies included Statistical Mathematics, Western Civilizations, Majoring in Psychology and Sociology
08/1986-5/1990 Stratford High School 1800 Stratford Avenue Nashville, Tennessee 37207
Studies included Honors English I &II, Algebra I &II and Trigonometry, Geometry and French I &II
5/2012-8/2016 University of Phoenix 1661 Marriott Blvd Nashville, Tennessee
Currently enrolled in Bachelor of Science Degree program to obtain degree in Healthcare Administration
Experience
May 2014- March 2020 CGS Administrators 2 Vantage Way Nashville, Tennessee 37202
Customer Service/Appeals Examiner
? Answer Medicare Part B provider calls
? Explain Medicare Part B claim denials and how to correct claim for payment
? Provider reference and resource material to
? Verify and confirm beneficiary eligibility in Medicare Part A and B
? Review appeal documents and send to clinicians
? Upload medical documentation in MAS appeal system
? Create appeal claims through document system
? Research claims and generate letters based on findings
September 2013-May 2014 CVS Caremark 445 Great Circle Road Nashville, Tennessee 37228
Customer Service
? Answer Medicare Part d member calls
? Explaining current Medicare D drug plan
? Taking medication refill orders
? Researching plan design copay structures and formulary changes
? Providing pleasant, accurate customer service
? Providing information regarding changes to Medicare Part D drug plan structures
? Providing Medicare mandates procedures and updates
3/1999-6/2013 Vanderbilt Medical Center 602 Oxford House Nashville, Tennessee 37232
Otolaryngology
Surgery Scheduler
? Coordinate surgery schedule with patient, physician and operating room.
? Arrange and schedule pre-operative test for patient.
? Maintains operating room schedule
? Give patient detailed information regarding dates, time scheduled and necessary instructions, as directed by physicians.
? Contact patient to remind of post-operative instructions, as directed by physicians..
? Working knowing in Star Panel, Epic Hyperspace, and other systems
? Verify patient eligibility and coverage for procedure and obtain pre-certifications
? Obtain precertification or proper insurance approval prior to surgical procedures
? Notify and forward paperwork for insurance certification to Billing Office and obtain additional paperwork if needed for compliance.
? Responds to written and telephone inquiries from carriers regarding surgeries
? Perform clerical duties to support the surgery scheduling function
? Provide support and necessary information to physicians regarding scheduling and patient information.
? Submitting Pre- determinations and appeals to insurance companies typing up appeal letters for denials
2/19/1996-3/1999 Vanderbilt Medical Center S-2100 MCN Nashville. Tennessee 37232
Otolaryngology
Office Assistant III
? Responsible for printing daily schedules to pull medical records for clinic appointments and surgeries .
? Filing labs, pathology reports, clinic and op notes
? Paperless Scanning procedures and indexing
? Making copies and faxing information to other clinics and doctor's offices
? Developed a logging process in order to archive inactive medical records on an annual basis
? Assisting medical students, doctors, nurses and secretaries archival retrieval
? Pick up, sort and distribute mail for clinic
01/1995-02/18/1996 Vanderbilt Temporary Service S-2100MCN Nashville, Tennessee 37232
Otolaryngology
Clerk III
? Responsible for filing of labs, pathology reports , insurance ,disability papers, clinic and op notes
? Printing daily schedules, pull medical records for clinic appointments and surgery
? Responsible for some supervisory duties including setting schedules and approving time off
? Handling daily medical records duties and delegating work assignments
Certificate thru Vanderbilt Training and Development Organizational Skills Certificate received on June 22, 2000.
Attendance in Tenncare in-service May 2003, January 2004, March 2004, July 2005, August 2005 for BCBS precerts
Working knowledge in Excel and with CPT coding, Completion of Administrative Assistants Conference September
2008
4124 Buenaview CT Nashville, TN 37218 ------------ Message Phone:------------ E-mail:------------
LAQONDIA VACHELLE WEAVER
Objective
To obtain a position in an organization that will allow the expanding of achieved skills while assisting to further enhance my performance at current job to gain work experience in clerical support with the opportunity for advancement.
Education
08/1990-05/1991 Belmont University, 2900 Belmont Boulevard Nashville, Tennessee 37212
Studies included Statistical Mathematics, Western Civilizations, Majoring in Psychology and Sociology
08/1986-5/1990 Stratford High School 1800 Stratford Avenue Nashville, Tennessee 37207
Studies included Honors English I &II, Algebra I &II and Trigonometry, Geometry and French I &II
5/2012-8/2016 University of Phoenix 1661 Marriott Blvd Nashville, Tennessee
Currently enrolled in Bachelor of Science Degree program to obtain degree in Healthcare Administration
Experience
May 2014- March 2020 CGS Administrators 2 Vantage Way Nashville, Tennessee 37202
Customer Service/Appeals Examiner
? Answer Medicare Part B provider calls
? Explain Medicare Part B claim denials and how to correct claim for payment
? Provider reference and resource material to
? Verify and confirm beneficiary eligibility in Medicare Part A and B
? Review appeal documents and send to clinicians
? Upload medical documentation in MAS appeal system
? Create appeal claims through document system
? Research claims and generate letters based on findings
September 2013-May 2014 CVS Caremark 445 Great Circle Road Nashville, Tennessee 37228
Customer Service
? Answer Medicare Part d member calls
? Explaining current Medicare D drug plan
? Taking medication refill orders
? Researching plan design copay structures and formulary changes
? Providing pleasant, accurate customer service
? Providing information regarding changes to Medicare Part D drug plan structures
? Providing Medicare mandates procedures and updates
3/1999-6/2013 Vanderbilt Medical Center 602 Oxford House Nashville, Tennessee 37232
Otolaryngology
Surgery Scheduler
? Coordinate surgery schedule with patient, physician and operating room.
? Arrange and schedule pre-operative test for patient.
? Maintains operating room schedule
? Give patient detailed information regarding dates, time scheduled and necessary instructions, as directed by physicians.
? Contact patient to remind of post-operative instructions, as directed by physicians..
? Working knowing in Star Panel, Epic Hyperspace, and other systems
? Verify patient eligibility and coverage for procedure and obtain pre-certifications
? Obtain precertification or proper insurance approval prior to surgical procedures
? Notify and forward paperwork for insurance certification to Billing Office and obtain additional paperwork if needed for compliance.
? Responds to written and telephone inquiries from carriers regarding surgeries
? Perform clerical duties to support the surgery scheduling function
? Provide support and necessary information to physicians regarding scheduling and patient information.
? Submitting Pre- determinations and appeals to insurance companies typing up appeal letters for denials
2/19/1996-3/1999 Vanderbilt Medical Center S-2100 MCN Nashville. Tennessee 37232
Otolaryngology
Office Assistant III
? Responsible for printing daily schedules to pull medical records for clinic appointments and surgeries .
? Filing labs, pathology reports, clinic and op notes
? Paperless Scanning procedures and indexing
? Making copies and faxing information to other clinics and doctor's offices
? Developed a logging process in order to archive inactive medical records on an annual basis
? Assisting medical students, doctors, nurses and secretaries archival retrieval
? Pick up, sort and distribute mail for clinic
01/1995-02/18/1996 Vanderbilt Temporary Service S-2100MCN Nashville, Tennessee 37232
Otolaryngology
Clerk III
? Responsible for filing of labs, pathology reports , insurance ,disability papers, clinic and op notes
? Printing daily schedules, pull medical records for clinic appointments and surgery
? Responsible for some supervisory duties including setting schedules and approving time off
? Handling daily medical records duties and delegating work assignments
Certificate thru Vanderbilt Training and Development Organizational Skills Certificate received on June 22, 2000.
Attendance in Tenncare in-service May 2003, January 2004, March 2004, July 2005, August 2005 for BCBS precerts
Working knowledge in Excel and with CPT coding, Completion of Administrative Assistants Conference September
2008