Insurance Medical
Resume:
Bridgette J. Wilson
____________________________________________________
Gahanna, OH 43230
Home: 216-***-****
abj2bv@r.postjobfree.com
Summary
College graduate seeks position in Human Resources.
Education
University of Cincinnati (Cincinnati OH)
B.A. in Psychology, June 2008
Professional Experience
Nationwide Children's Hospital, Columbus OH 2010-Present
Client Account Specialist II - Insurance Billings
Maintaining files and updating information regarding all third party payors
with which the agency has a specific billing arrangement. Setting up and
maintaining detailed files for all insurance eligible clients. Preparing
and submitting insurance billings on a monthly basis to the appropriate
organization. Following up monthly on all outstanding receivables utilizing
correspondence, phone calls, and client contact as necessary to ensure
timely and maximum reimbursement for services. Inputting insurance
payments, encompassing any adjustments and transfers (ADAMH and Medicaid).
Coordinating private insurance and medical billing for maximum
reimbursement. Computing and posting adjustments to include client account
adjustments, client/insurance refunds, and bad debt. Transferring or
deleting charges erroneously placed on client accounts. Acting as a liaison
between the Guidance Centers and third party payors in resolving billing
and reimbursement issues. Submitting secondary and tertiary insurance.
Identifying payor problems and initiating recommendations to the
Administrative Coordinator and/or the Finance Manager. Reviewing monthly
statements for exactness.
The Huntington Bank, Columbus OH 2008-2010
Process Assistant (Wholesale Lockbox)
Providing payment processing service for banking clients in the Wholesale
Lockbox department. Sorting and opening mail. Extracting payments and
invoices. Data entry and amount verification. Image scanning and check
encoding. Combining check images and invoices, and preparing both for
mailing to clients. Maintaining low error and high production rates while
completing a high volume of work, extracting at least 115 items per hour
and combining at least 326 items per hour.
Progressive Medical, Inc., Columbus OH 2005-2007
Client Services Associate/Medical Billing (Passthrough Dept.)
Providing billing services for insurance companies and non-Progressive
Medical affiliated vendors. Receiving faxed and/or emailed referrals from
various medical equipment providers, and notifying providers of referral
receipt. Inputting new patient, insurance claim, and medical information
into Oracle. Documenting all claim activities on each file. Faxing,
emailing and/or instant messaging requests for authorization to insurance
adjusters and nurse case managers for rental and/or purchase of Durable
and electromedical equipment and supplies for injured claimants.
Negotiating prices with providers based on the Medicare Fee Schedule.
Fulfilling adjusters' requests to initiate billing through Progressive
Medical, Inc for the purpose of cost containment. Faxing doctor's
prescriptions, Letters of Medical Necessity, Usage Reports, and
electromedical product information to insurance contacts upon request.
Documenting authorization or denial upon receipt. Invoicing approved
equipment and forwarding invoice numbers to providers for release of
equipment and supplies. Forwarding denial letters to providers, including
the reason for denial. Filing completed referrals alphabetically.
Completing a daily assignment of work in a timely and efficient manner.
Assisting other associates with completion of their individual schedules as
needed. Training new billers and cross-training other specialists in
Passthrough billing.
JPMorgan Chase (Chase Home Finance), Columbus OH, 2003-2005
Customer Care Professional II
Answering customer inquiries about their mortgage accounts via inbound
calls, specifically focusing on tax, escrow, and mortgage payment issues.
Ensuring customer satisfaction by maintaining call quality scores of 80% or
above and average call times of 350 seconds or less. Blending effective
time management and problem solving skills in order to meet or exceed
departmental goals and to ensure a high level of productivity. Using
superior written and verbal communication skills to document calls, assist
fellow representatives, and to create a "wow" experience for every
customer. Sending work orders to various internal departments for prompt
resolution of customer issues. Advising customers of work order status and
estimated turnaround time for completion. Cross-selling Chase products,
such as credit cards and home equity loans, to current mortgage customers
to solidify customer loyalty and to maintain a business relationship with
our customers. De-escalating hostile calls.
The Metrohealth System, Cleveland OH, 2002-2003
Research Project Associate
Randomizing groups and screening medical charts of hemodialysis patients to
include and exclude participants for an NIH-funded and IRB-regulated
research study. Recruiting and performing monthly interviews with 21 study
participants in seven northeast Ohio inpatient and outpatient hemodialysis
centers. Administering physical examinations, and nutritional and
psychosocial tests, including the Beck Depression Inventory (BDI) and
monthly food recalls. Utilizing effective time management and
organizational skills to plan and prioritize work schedule and to meet
weekly project deadlines. Developing and applying excellent verbal and
written communication skills through patient interviews, interaction with
dialysis center staff, and weekly team meetings with study physicians and
fellow research staff. Performing clerical functions using programs such as
Excel and Jump on both IBM and Macintosh computer systems. Specimen
collection, storage, and processing for analysis of protein and other
nutrient levels. Maintaining patient anonymity according to HIPAA and
Institute Review Board (IRB) study regulations with the use of patient and
facility codes, and by destroying personal participant information via
shredders and locked recycling bins. Working closely with several
physicians, administrative professionals, and a team of registered
dieticians to compare and analyze research findings.
Computer Skills
Typing speed of 60 wpm and 18,000 keystrokes per hour with an average of
100% accuracy, as evidenced by most recent typing test. Proficient in
Microsoft Office 2007, including Word, Outlook, PowerPoint, Access, and
Excel. Knowledge of statistical analysis programs SAS and SPSS. Expert in
HTML, Web Page Design, and Internet searches. Experienced in using the
randomization program Jump, and in creating spreadsheets using QuattroPro.
Experienced in using Mainframe, Oracle and Lotus Notes.
Additional Skills and Training
Trained in research methodology and analysis, and writing psychological
reports using APA format. Advanced-level college coursework focusing on
abnormal psychology, developmental psychology, and organic brain disorders.
Exceptional mathematical aptitude, and verbal and written communication
skills. Experienced media journalist and former University of Cincinnati
news reporter.
Salary Requirements: Open
References available upon request.
Contact this candidate