Natasha McLean

Dedicated healthcare and administrative professional with 15+ years of experience in claims processing, Medicare enrollment, data entry, customer service, accounts payable/receivable, and office administration. Skilled in resolving billing issues, maintaining HIPAA compliance, and supporting high-volume operations with accuracy and professionalism.

STATEWIDE CALL-IN PRICING REPRESENTATIVE - FIRSTSOURCE HEALTH - Remote

(2026-03)

• Review and analyze healthcare claims for pricing accuracy, reimbursement determination, eligibility verification, and claim resolution.
• Investigate claim discrepancies, underpayments, overpayments, denials, and rejected claims.
• Analyze member eligibility, benefits, authorizations, and supporting documentation across multiple healthcare systems.
• Process claim adjustments and coordinate escalations involving nursing review, authorization issues, and membership discrepancies.
• Maintain detailed claim documentation while ensuring HIPAA compliance.
• Collaborate with internal departments to resolve complex claims accurately and efficiently.

MEDICARE ENROLLMENT SPECIALIST / DATA ENTRY SPECIALIST - FIRSTSOURCE HEALTH - Remote

(2025-07 - 2026-03)

• Processed Medicare Advantage enrollments and re-enrollments for Blue Cross Blue Shield of Michigan members.
• Verified eligibility and updated member records in accordance with CMS regulations.
• Managed address changes, plan updates, subsidy adjustments, disenrollments, and member record maintenance.
• Performed high-volume data entry while maintaining accuracy and productivity standards.
• Utilized Citrix, Facets, CMS, Workflow Manager, Amazon Connect, Verint, Excel, and Microsoft applications to complete enrollment activities.

OWNER / MANAGER - VAPORS LOUNGE - Chesterfield, VA

(2009-09)

• Manage daily business operations including accounts payable, accounts receivable, payroll processing, budgeting, inventory management, and vendor relations.
• Prepare financial records, oversee cash flow management, and maintain accurate business documentation.
• Recruit, train, supervise, and evaluate employees.
• Coordinate purchasing, inventory control, and vendor negotiations.
• Successfully transitioned business operations to an online retail model.
• Provide operational consulting and business guidance to new entrepreneurs.

CUSTOMER SERVICE REPRESENTATIVE / DATA ENTRY SPECIALIST - WORKING SOLUTIONS - Remote

(2022-12 - 2023-05)

• Processed airline refund requests by reviewing documentation and determining eligibility.
• Performed data entry and maintained accurate customer records.
• Provided customer support for tax software users through phone and online channels.
• Assisted customers with account navigation, troubleshooting, and technical support.
• Maintained quality standards while meeting productivity goals.

DRIVER (PART-TIME) - TRUEHEART TRANSPORTATION - Henrico, VA

(2019-09 - 2020-04)

• Maintained accurate transportation records and trip documentation.
• Ensured compliance with safety procedures and scheduling requirements.
• Demonstrated reliability, time management, and strong recordkeeping skills.

ONE-ON-ONE BEHAVIOR AIDE (PART-TIME) - MENDING FENCES, LLC - Richmond, VA

(2018-09 - 2019-06)

• Maintained detailed behavioral records and prepared monthly progress reports.
• Documented student performance and communicated updates to educational staff and families.
• Supported compliance with educational and behavioral support plans.

DIRECT SUPPORT PROFESSIONAL / BEHAVIOR AIDE - HAVE FAITH RESIDENTIAL - Richmond, VA

(2015-03 - 2018-12)

• Maintained detailed client documentation, progress notes, and incident reports.
• Assisted with daily living support and behavioral management services.
• Coordinated transportation, appointments, and community integration activities.
• Ensured compliance with agency policies and documentation requirements.

CUSTOMER SERVICE REPRESENTATIVE / DATA ENTRY SPECIALIST - BON SECOURS HEALTH SYSTEM - Henrico, VA

(2007-02 - 2009-03)

• Assisted patients with billing inquiries, account resolution, and payment arrangements.
• Processed payments and maintained accurate patient account records.
• Performed data entry and documentation to support revenue cycle operations.
• Provided professional customer service while handling confidential information.

MEDICAL BILLING CUSTOMER SERVICE REPRESENTATIVE / DATA ENTRY SPECIALIST - ANTHEM BLUE CROSS BLUE SHIELD - Henrico, VA

(2003-05 - 2007-01)

• Assisted healthcare providers with claims status inquiries, billing concerns, and payment issues.
• Investigated, corrected, and documented claim and coding errors.
• Facilitated claim resubmissions and ensured compliance with insurance guidelines.
• Maintained accurate records and supported claims resolution activities.
• Delivered high-quality customer service to providers and internal stakeholders.

High School Diploma - Leilehua High School