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Customer Service Representative

Location:
Rowlett, Texas, United States
Posted:
January 06, 2018

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Resume:

PAULA LOUISE MOLTKE

Rowlett, Texas *****

Cell **4- 460-7175

Email ac3xl6@r.postjobfree.com

QUALIFICATIONS

My greatest attribute is my dependability for any task I am assigned. I will follow through to the ultimate

conclusion of the task

I work well in a team environment. I am comfortable in the position of leader or team player

I can adapt to different situations or company policies

EMPLOYMENT

Owner/agent

Moonlight Bay Travel Agency Years Employed October 1, 2014 to current

Specializing in Cruises

Billing Specialist

Charge entry

Med3000/McKesson Years Employed 11/5/2012 to 6/29/2014

Posting charges from physicians for transplant related services and billing them. Entering charges for

clinical services and evaluations. Verify all information for demographics is correct. If changes are

required, these are made prior to entering charges. QA previous work entered and scanned to ensure that

everything is correct and billed.

Reimbursement Specialist

Revenue Specialist

Odyssey Healthcare/Gentiva YEARS EMPLOYED 5/5/2008 TO 9/30/2011

Responsible for running reports for monthly billing for 23 sites. Reports involved are bill register, bill

process, transaction register ( revenue), bill hold reports and room and board detail. Enter claims from

mock claims printed from bill process into the specific state billing software. After billing the claims

check the denial register so if claim did not go through research can be done in order to correct any errors

that may be causing the claim to deny. After errors have been resolved, rebill to get clean claim.

Work the aging report to see why claims are still open. Determine if claims are rebillable or if they will require being written off. Helping each site with any invoicing problems they might have issues with. Make sure charges are entered correctly/generate charges. Run reports as needed verifying all information

is correct. Make corrections as needed.

Billing Specialist

OrthoRX YEARS EMPLOYED 9/2004 TO 3/2008

Responsible for accurate and timely booking of new accounts and charge orders within the billing system to

insure submission of clean claims per payer filing time frames. Other duties and responsibilities include:

perform quality control on new accounts and charge orders per policies and procedures; obtain daily

coversheets or paperwork for accounts to be worked or entered into billing system; work as a team with

Center personnel to insure accurate and timely selection of open charge orders; review assigned payer sites

for medical policy changes, manual updates and provider bulletins; review and verify all insurance requests

within 24 hours of receipt; communicate process or payer requirements/changes to Center personnel;

demonstrate a strong working knowledge of billing system functions to effectively execute job dutiees; demonstrate a strong working knowledge of ICD-9, CPT, and HCPCS codes and HIPAA laws; prepare adjustments for A/R for approval and processing

Transplant Billing Specialist

Kelly Services/Baylor Hospital/EDS YEARS EMPLOYED 6/2003 TO 7/2004

Bill transplant claims for Baylor Medical Center and Baylor All Saints, manage bill hold reports, rebill claims as needed, work with

spreadsheets keeping track of transplant days/date of admit/collections that are needed after cycle billed, work untransmitted report for

NEIC and paper claims, collections

BUSINESS OFFICE COORDINATOR YEARS EMPLOYED 4/2000 TO 2/2003

VENCOR HOSPITAL DALLAS EAST

Set up overall functions of business office. Brief description of functions were key punch, AP/AR, entering information into

previously prepared spread sheets, reconciliation, trouble shoot, billing, collecting, insurance verification and other daily office

functions. Prior to this my functions were administrative duties which included HR, Medical Staff Credentialing, Benefits, and

payroll. And Verification of licensure and daily deposits

Customer Service Representative Years Employed 2/97 to 2/2000

Southwestern Financial

Dallas, Texas

Submitting and processing new applications, submitting and processing internal exchanges and 1035

exchanges, issuing new policies and troubleshooting, underwrite up to $150000,

Assist policy holders with insurance problems, processing loans and partial withdrawals,

also assist agents with existing and new business, additional task include title changes

which includes entering absolute assignments, beneficiary changes, ownership changes,

social security corrections and additions, phone number and address changes

BILLING SPECIALIST YEARS EMPLOYED 11/94 TO 2/97

VENCOR HOSPITAL DALLAS EAST

Long term acute care

DALLAS TEXAS

Filing claims electronically to Medicare for 4 hospitals. Filing secondary claims to individual insurance, file workers comp claims,

Medicaid and filing to other primary carriers. Assisted in collections. Admit/ discharging patients, filing, front desk, training new

employees and making daily deposits

CUSTOMER SERVICE REPRESENTATIVE YEARS EMPLOYED 5/85 TO 11/94

UNITED AMERICAN INSURANCE CO

DALLAS TEXAS

Assist doctors and hospitals with claims and benefits dealing with Medicare supplements and major medical/surgical policies, in

addition, experienced with policy holder complaints, claims and adjustments, also experienced with switchboard operations and

assisting with agents leads

EDUCATION

Temple High School Temple Texas

GED

Dallas Police Academy Arlington Texas

Public Safety Certificate

Basic Dispatch Training Certificate

Public Safety Emergency Dispatch Course Certificate

Insurance Educational Progression Dallas Texas

Loma I certified

Loma II certified

Medical Terminology – certificate

Connelly Air Force Base Waco Texas

Office/ Business machine Training

Eastfield College Mesquite Texas

Typing I

Supervisory skills

I have successfully competed and received certification in supervisory skills.

SKILLS

SKILLS

Filing electronically with modem and Windows 95 and 98, Microsoft Word-exchange and some excel, 10 key, type 30wpm, alpha and

numeric filing, inventory control, order pulling and stocking. Knowledgeable in inbound and outbound telecommunications, Pitney

Bowes, addressograph, also knowledgeable in CK-4 mainframe, Citrix, EDS, Lotus Notes, Outlook, Vantage, Sap, ADP,

Meditech, Millbrook, Paradigm,MSO-Medical Staff Credentialing, Ventouch., Citrix, Patcom, Premis, X-Med, Tims,DSS, I-Suite,

payerpath, state Medicaid systems for Pennsylvania, Nevada, Utah, Texas and Delaware, Alabama, Georgia, Arkansas, New Jersey,

medical terminology, payroll, cashier, customer service, human resources, administrative duties and switchboard Extensive

knowledge in PPO, EPO, HMO, Medicare, Medicare Supplement, Medicaid and Workers Comp. Strong knowledge of ICD-9, CPT,

HCPCS codes and HIPPA laws. Generating revenue for California, NM, Texas and Oregon.



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