Insurance Medical

Bridgette J. Wilson

____________________________________________________

**** ******** **, *** *

Gahanna, OH 43230

Home: 216-***-****

*************@*****.***

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