Customer Service Insurance

Felicia Annette Outlaw

PO Box ******

Tampa, FL 33694

321-***-**** (C)

Email: acee4r@r.postjobfree.com

Objective: To acquire a position that would allow me advancement

opportunities, to improve, grow and establish a career.

Work Experience

Florida Hospital Laboratories- 7/13- Present

Insurance Reimbursement Billing Specialist- Work with insurance payors to

ensure proper reimbursement on patient accounts to expedite resolution.

Process appeals, refunds, reinstatements and rejections of insurance

claims. Complete account follow up daily and analyze daily correspondence

(denials, underpayments) to resolve issues. Assist customer service with

patients concerns/questions. Initiates next billing, follow-up and

collections and remits initial or secondary bills to insurance companies.

WellCare Health Plans- 08/09- 6/13

Finance/COB Specialist- Initiates contact to other insurance companies to

gather coordination of benefits (COB) data. Consolidates the activities

that support the collection, management and reporting of other insurance

coverage. Responsible for investigating all potential Third Party

Liability cases for customer members. Maintains and document accurate

member other coverage information within Xcelys and COB database

application. Handles all COB inquiries requiring detailed, in-depth

investigations while maintaining an acceptable quality audit score and

productivity. Assists COB Supervisor with training new hires. Serves as

mentor for existing COB Specialists and all new hires to the department;

acts as a Subject Matter Expert (SME). Assists team members by guiding

them to the appropriate resolution of more complex or difficult cases.

United Healthcare-10/08-5/09

Claims Associate- Responsible for providing general claims support to teams

in reviewing, researching, investigating, negotiating, processing and

adjusting claims. Authorizes the appropriate payment or refers claims to

investigators for further review. Conducts data entry and rework.

Patient Financial Services/ UNC-7/07- 6/08

Patient Account Representative II- Followed-up/worked claims denied by

Medicaid and re-billed for payment. Responsible for pursuing collection on

UNC Hospital accounts until payment is made in an efficient and timely

manner. Correct contractual adjustments and allowances, transfer balances,

and payment posting, account receivables. Insurance data entry. Maintain

production weekly set by management.

Caring Family Network-10/04-04/07

Billing Specialist- Billed Medicaid electronically, Healthchoice and other

payers for services provided by mental health agency. Created and

processed invoices in Quick Books for billable hours. Maintained and

tracked all treatment plans and authorization for expiration date, and

review dated. Maintain and update account receivable log. Review and re-

work denials and resubmit for processing.

Duke PRMO- 2/17/03-9/04

Patient Financial Svc. Rep. - Perform a variety of specialized clerical

tasks. Followed up with insurance companies for claim status. Work claims

denied by insurance companies and file for payment. Make sure that

financial obligations are fulfilled on behalf of the patient for healthcare

services and procedures performed. Maintain production weekly set by

management.

Duke University Medical/CHC - 7/01-02/03

Clinic Service Coordinator - Coordinate and registered patients for clinic

services; Provided general information regarding admission, made

appointments, scheduled lab test and maintained current address information

on clinic patients. Assisted patients with registration procedure to

include providing information regarding accommodations and insurance.

Answer telephone, request laboratory, x-ray and other patient reports.

Modus Media International - 7/00-06/01

Call Center Supervisor - Supervise day-to-day operations on the response

center floor. Monitor calls for quality assurance. Coordinate hiring for

positions. Manage statistical reports. Conduct performance reviews.

Attend conference calls and supervisory meetings. Train new hires.

Deliver world-class customer service to customers.

Certifications/Skills: Windows 95/97, MS Scheduler, MS Word, Internet,

Power Point, Excel, AS400, Sips, PDS, Customer service, Account Receivable,

Insurance Claims Status, Supervise, Interviewing, Blue E, Browser, HDS,

QuickBooks, EDS, MS Outlook, Siemens (A2K), CT Vision, Sovera, Passport,

Web MD, IDX, Oracle

Education

Hillsborough Community College, Tampa, FL Medical Billing/Coding

Pursuing)

Hillside High School, Durham, NC

Contact this candidate