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 seeking to join a growing organization to increase corporate bottom line. A meticulous professional who has firm grasp of this industry.

Skills

●  TruCare/WebCM/ CRM/Amisys/ECCPIS Proficient

●  HIPAA Certified

●  Oracle/Integrimatch/SAP Proficient

●  CPT, ICD-9-CM, HCPS Coding proficient

●  Anatomy, Physiology, and Medical Terminology Proficient

●  Claimsgear and Medisoft Billing System and EOB resolution proficient

●  Skilled Microsoft Word, Outlook, and Excel

●  Windows XP and Vista

●  Data Entry, Alpha Numeric typing and Filing/8000/KSPH/60 WPM

Education

Associates Degree 2010 Medical Insurance Billing & Coding

Experience

Centene-Westmont, IL                 11/2014-CurrentProgram Coordinator I (Illinicare Health)

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 potential system problems and claims training issues. 

Prepare and Initiate Inpatient and outpatient authorizations

Attend departmental training 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 the review of various claims reports and perform other health administrative duties. 

Referral Specialist I (Illinicare Health)         Processing of outpatient waiver and some inpatient authorizations listed within TruCare system.

Keep up with updates and changes in policy and procedures as well as being able to adapt and learn system use for

CRM, Amisys, WebCM and Trucare.

Timely completion and accurate data entry of all home based services task.

Research, correct or update any authorizations that show up on any error report received from claims.

Attend training and compliance sessions as scheduled.

Complete custodial auths for LTC members, which includes closing, opening, or discharging authorizations when a

member leaves or returns to a nursing home.

Monthly maintenance of termed member spreadsheets.

Work on special projects assigned by supervisor

Various other duties

Medix-Chicago, IL                 3/2014-7/2014Medicaid Cash Poster (Season’s Hospice)

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, prepare invoices for hospice patients to be processed for payments and prepare spreadsheets for

payments. 

Help prepare and organize payments and checks to be mailed to nursing homes for hospice services

Have worked in billing/review department.

Randstad-Chicago, IL                 12/2012-3/2014Affordable Care Act Enrollment Specialist (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 the phone 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.               Medicaid Eligibilty Specialist (Maximus)

Review redetermination cases sent by the client through work queues assigned by the Eligibility Supervisor.

Evaluating data provided by the verification system against State eligibility requirements Review documentation sent in

by clients to make accurate determinations on whether the client 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.

Make recommendation and determinations on Medicaid coverage for clients

Club Assist-Chicago, IL.                 10/2012-6/2013Data Entry/Accounts Receivables

Manage financial of auto parts sold and received

Enter Cash Receipts

Manage Invoice Records and record all revenue paid and owed

Prepare and manage spreadsheets of revenue records

Chiro One Wellness Centers-Oak Brook, IL.           01/2011-07/2012Data Entry/Cash Receipt Specialist

Reconcile bank account statements

Manage financial using QuickBooks accounting program

Verifying Debits and Credits posted to accounts

Follow through on timely and accurate month-end closings

Create financial reports to show statistics, such as cash receipts, accounts payable and receivables, etc.

Enter cash receipts, charge-backs and refunds

Checked balances in general ledgers

Balance daily totals to system and prepare bank deposits

Record EFT payments and notify clinics of receipt

Various other accounting functions