Jessika Shuller

Functions included insurance verification processing for Medicare, Medicaid and national private insurance programs. As well as appointment arranging associate. Computer programs used: Cerner, EPIC and Microsoft related programs.

Providing enrollment of Medicare Providers to the Medicare program per CMS, State and Federal guidelines. Also ensuring daily customer service and direct contact with both hospitals and doctors offices representing strong customer service and knowledge requirements. This also entitles completing CMS testing on systems such as PECOS, MCS and SHACK. This job function requires ensuring policy and procedures are up to date with current work as well as maintaining accurate work by other staff as an internal Quality Control Auditor within the department. This position entitles working and completing reports requested by CMS for re-validation, infrequent billing, specialty applications, congressional cases, priorities and critical inquires and revocations of license. Programs used daily: CMS approved software; including but not limited to Microsoft Word/Excel/Outlook, FISS, Mainframe, MCS, HIGLAS, PECOS, NPPES, HOD, M2, Imaging and Deltek. As an employee a must of compliance is met within means for confidentiality.

Support specialist, electronic data interchanging, internal controls, reading claims, ensuring policy and procedures are up to date with current work. Also includes enrolling providers for electronic data and customer service calls. Maintaining accurate work. This position entitles working and completing such with CMS approved software. I also work with computer programs such as Microsoft Word/Excel/Outlook, FISS, Mainframe, MCS, Pecos, NPPES, HOD, M2 and Deltek. Working with seniors to ensure the staff follows CMS guidelines and procedures. Working on such accesses such as DDE access request, FTP Access, EDI access and claim submission. This position also entitles that all requirements are met on an 855 provider enrollment application also ensuring that Tie-Ins are properly worked and on a timely basis. This includes troubleshoot with providers to ensure they are happy with the work we do and that all issues are completed. Making sure compliance is within means for confidentiality.