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Bianca Ware
6305 Flowerfield Lane Apartment 104 ▪ Raleigh, NC 27606 ▪ 919-605-1074 ▪ bware1208@gmail.com
PROFESSIONAL PROFILE
Customer service oriented professional backed by strong communication skills who monitors workflows and ensures
the achievement of department goals. Pays close attention to detail to ensure accurate and compliant documentation.
Ability to discreetly manage large amounts of sensitive and confidential information.
 Experience with Microsoft Word, Excel, PowerPoint, and Outlook.
 Leads by example and sets high standards for performance.
 Follows policies to ensure consistent standards.
KEY QUALIFICATIONS
ICD-10-CM ▪ CPT Coding ▪ Medical Terminology ▪ HIPAA Compliance ▪ Quality Assurance
Insurance Verification ▪ Insurance Billing Procedures ▪ Electronic Payment Posting ▪
▪ EHR/EMR ▪ Office Management ▪ Insurance Claim Processing
Master Patient Index ▪ Accounting ▪ Quickbooks ▪ Payroll ▪ Sales ▪ Claims Xten ▪ MACESS ▪ Medisoft
EDUCATION
Colorado Technical University, 10/2017
Bachelors in Science Degree – Finance
Colorado Technical University, 02/2016
Associate in Science Degree – Accounting (GPA: 3.3)
Las Vegas High School, 06/2007
Diploma -- (GPA: 3.5)
WORK EXPERIENCE
Center for Employment Training, Durham, NC 04/16 – Current
Medical Insurance Billing Instructor and Advisor
 Demonstrate a thorough and accurate knowledge of billing procedures
 Teach double course load
 Plan and organize instruction in way that maximize documented student learning
 Demonstrate sensitivity to student needs and circumstances
 Evaluate student performance
Achievements: As the medical insurance billing instructor I was able to learn and use technology to enhance
teaching and educational experience when appropriate. I was able to keep the attention of my students by relating
their course work to current topics in their field. Along with medical insurance billing I teach medical office
administrative procedures. I was ableto teachstudents with no prior medicalhistory medicalterminology, anatomy
and physiology, book keeping techniques, accounts receivable, accounts payable, and other course requirements.
Manpower at Blue Cross Blue Shield, Durham, NC 11/2015 – 04/2016
Medical Claims Quality Auditor
 Performs quality audits of all medical claims
 Addresses inquiries received from internal and external
 Provides cross-functional support for operational functions, including development training, one-on-one
coaching and feedback, trending, or complex root cause analysis
 Provides objective feedback and recommends corrective actions and process
Achievements: Consistently met daily goals with a 100% accuracy audit rate. Expanded my knowledge in
commercial, large group, and small group billing and claims. Help integrate Facets into the daily business needs as
well as help train offshore auditors.
Humana Healthcare, Cary, NC 09/2011 – 11/2015
Customer Service Team Lead
 Read claims, interpret EOBs/EORs for members and providers
 Send claims for reprocessing when there is an error
 Assist members in grievance and appeals rights, procedures, and status
 Explain healthcare insurance policies including benefits and eligibility, pharmacy and medical claims
 Process payments and answer medical billing and enrollment questions
 Calculate premiums and establish payment methods
 Train new hires
 Train on Medicare/Medicaid Appeals process
Achievements: Lead my team to consistently exceed monthly target goals in quality assurance, ECHO surveys, and
phone time metrics. Created and delivered performance improvement plans for team members. Received training and
certificates in pharmacy benefits, pharmacy claims, medical benefits and eligibility, medical claims, medical billing
and enrollment
TGI Fridays Restaurant, Raleigh, NC 08/2010 – 09/2011
Lead Waitress
 Managed up to 5 tables at one time
 Processed and served orders for food and drinks
 Keep self, section, and kitchen clean and presentable
 Trained and delegated employees
Bright Beginnings, Las Vegas, NV 01/2008 – 06/2010
PreK Teacher
 Manage classroom of preschool students
 Create and carry out lesson plans
 Interact with parents on daily basis about their children

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Ware resume

  • 1. Bianca Ware 6305 Flowerfield Lane Apartment 104 ▪ Raleigh, NC 27606 ▪ 919-605-1074 ▪ bware1208@gmail.com PROFESSIONAL PROFILE Customer service oriented professional backed by strong communication skills who monitors workflows and ensures the achievement of department goals. Pays close attention to detail to ensure accurate and compliant documentation. Ability to discreetly manage large amounts of sensitive and confidential information.  Experience with Microsoft Word, Excel, PowerPoint, and Outlook.  Leads by example and sets high standards for performance.  Follows policies to ensure consistent standards. KEY QUALIFICATIONS ICD-10-CM ▪ CPT Coding ▪ Medical Terminology ▪ HIPAA Compliance ▪ Quality Assurance Insurance Verification ▪ Insurance Billing Procedures ▪ Electronic Payment Posting ▪ ▪ EHR/EMR ▪ Office Management ▪ Insurance Claim Processing Master Patient Index ▪ Accounting ▪ Quickbooks ▪ Payroll ▪ Sales ▪ Claims Xten ▪ MACESS ▪ Medisoft EDUCATION Colorado Technical University, 10/2017 Bachelors in Science Degree – Finance Colorado Technical University, 02/2016 Associate in Science Degree – Accounting (GPA: 3.3) Las Vegas High School, 06/2007 Diploma -- (GPA: 3.5) WORK EXPERIENCE Center for Employment Training, Durham, NC 04/16 – Current Medical Insurance Billing Instructor and Advisor  Demonstrate a thorough and accurate knowledge of billing procedures  Teach double course load  Plan and organize instruction in way that maximize documented student learning  Demonstrate sensitivity to student needs and circumstances  Evaluate student performance Achievements: As the medical insurance billing instructor I was able to learn and use technology to enhance teaching and educational experience when appropriate. I was able to keep the attention of my students by relating their course work to current topics in their field. Along with medical insurance billing I teach medical office administrative procedures. I was ableto teachstudents with no prior medicalhistory medicalterminology, anatomy and physiology, book keeping techniques, accounts receivable, accounts payable, and other course requirements. Manpower at Blue Cross Blue Shield, Durham, NC 11/2015 – 04/2016 Medical Claims Quality Auditor  Performs quality audits of all medical claims  Addresses inquiries received from internal and external  Provides cross-functional support for operational functions, including development training, one-on-one coaching and feedback, trending, or complex root cause analysis  Provides objective feedback and recommends corrective actions and process
  • 2. Achievements: Consistently met daily goals with a 100% accuracy audit rate. Expanded my knowledge in commercial, large group, and small group billing and claims. Help integrate Facets into the daily business needs as well as help train offshore auditors. Humana Healthcare, Cary, NC 09/2011 – 11/2015 Customer Service Team Lead  Read claims, interpret EOBs/EORs for members and providers  Send claims for reprocessing when there is an error  Assist members in grievance and appeals rights, procedures, and status  Explain healthcare insurance policies including benefits and eligibility, pharmacy and medical claims  Process payments and answer medical billing and enrollment questions  Calculate premiums and establish payment methods  Train new hires  Train on Medicare/Medicaid Appeals process Achievements: Lead my team to consistently exceed monthly target goals in quality assurance, ECHO surveys, and phone time metrics. Created and delivered performance improvement plans for team members. Received training and certificates in pharmacy benefits, pharmacy claims, medical benefits and eligibility, medical claims, medical billing and enrollment TGI Fridays Restaurant, Raleigh, NC 08/2010 – 09/2011 Lead Waitress  Managed up to 5 tables at one time  Processed and served orders for food and drinks  Keep self, section, and kitchen clean and presentable  Trained and delegated employees Bright Beginnings, Las Vegas, NV 01/2008 – 06/2010 PreK Teacher  Manage classroom of preschool students  Create and carry out lesson plans  Interact with parents on daily basis about their children