Derrick Strover Duncan
Minneapolis
Summary
Software engineering professional with entry-level experience specializing in software development, computer science, Python, and JavaScript. Proven track record of executing complex technical projects for the development and implementation of CRM tools. Adept at developing custom software solutions for client businesses. Proven ability to translate complex technical concepts into actionable business requirements. Seeking to leverage technical expertise and problem-solving skills, driving process improvements and delivering impactful solutions.
Overview
2
2
years of professional experience
Work History
CW Optum Insurance Representative Senior
Optum
05.2024 - Current
- Handled correspondence, scheduling and contracts for appearances.
- Generated and proofread professional business correspondence, financial reports, and tracking spreadsheets.
- Completed reports, charting, scheduling, and daily correspondence.
- Handled incoming calls and correspondence and responded as directed.
- Typed up professional business correspondence, reports, and other documents.
- Responded to correspondence from insurance companies.
- Handled incoming calls and correspondence to respond to questions and inquiries.
- Supported office manager with proactive correspondence management, document coordination, and customer relations.
- Understand edits and appropriate department procedures to effectively submit and/or correct errors on claims to the production standards of the department.
- Advanced knowledge and understanding to process third party rejections using the Payor system and the billing system. Follow-up on open accounts receivable, re-filing and department status procedures.
- Utilize Epic and various systems and demonstrate understanding of procedures for registration/verification modules, Claims Processing system, Web based provider systems, etc, if applicable to position • Trend analysis, Appeals and Resolves of low payment or underpaid accounts Reports to lead and or supervisor observations of WQ’s and workflow processes that may need further review and or development • Process and resolve complex denials related to coding and site operations (i.e.: CPT related, medical necessity, RAC technical denials etc).
- Ability to deal with difficult revenue cycle situations and resolve issues delaying/preventing payments from 3rd party payers.
- Provide job shadowing/basic training to other team members on the specific nuances of various job functions.
- Assists in the design and development of department policies, procedures and tip sheets.
Senior Insurance Specialist
Allina Health
09.2022 - Current
- Understand edits and appropriate department procedures to effectively submit and/or correct errors on claims to the production standards of the department
- Utilize various resources such as third-party publications, procedure manuals and participating contractual agreements, etc
- To reconcile accounts
- Advanced knowledge and understanding to process third party rejections using the Payor system and the billing system
- Follow-up on open accounts receivable, re-filing and department status procedures
- Utilize Excellian and various systems and demonstrate understanding of procedures for registration/verification modules, Claims Processing system, Web based provider systems, etc, if applicable to position
- Trend analysis, Appeals and Resolves of low payment or underpaid accounts
- Reports to lead and or supervisor observations of WQ's and workflow processes that may need further review and or development
- Process and resolve complex denials related to coding and site operations (i.e.: CPT related, medical necessity, RAC technical denials etc)
- Ability to deal with difficult revenue cycle situations and resolve issues delaying/preventing payments from 3rd party payers
- May be asked to provide job shadowing/basic training to other team members on the specific nuances of various job functions
- May assist in the design and development of department policies, procedures and tip sheets
- Attend and participate in biweekly staff meetings and any other meetings andor training sessions as indicated
- Extreme ability to organize and track large amounts of data
- Verification Benchmarks are met on a time frame as established by Management
- Ability to work in multiple software programs
Education
Bachelor of Science - Software Engineering
St. Cloud State University
St. Cloud, MN05-2025
Associate of Science - Engineering
Anoka Ramsey Community College
Coon Rapids, MN08-2023
Skills
- Python
- Javascript (NodeJS, ReactJS)
- SQL (MySQL)
- Unix
- GIT
- C/C
- Web Development & Database
- Data analysis
- Process modeling and analysis
- Requirements management
Timeline
CW Optum Insurance Representative Senior
Optum
05.2024 - Current
Senior Insurance Specialist
Allina Health
09.2022 - Current
Bachelor of Science - Software Engineering
St. Cloud State University
Associate of Science - Engineering
Anoka Ramsey Community College
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