Customer Service Insurance
Resume:
DONA C WESLEY
Pasadena, CA 91107
SUMMARY OF QUALIFICATIONS AND SKILLS
Customer Service Skills
Excellent organizational, analytical and problem solving skills
Accounts Payable, Accounts Receivable, posting payments, adjustments, and refunds
Computerized Accounting Systems
Microsoft Word, Excel, Outlook, WordPerfect, AS400
Lotus Notes, Electronic Data Exchange, Occupational Health Services Management
Patient registration, Patient check-in/check-out, Collect Co-pays
Health Insurance; authorizations/referrals, insurance verification, TPL payments,
Durable Medical Equipment, HCPCS, CPT,
HIPAA, Ethics Compliance, OSHA,
Research skills, tracking, retrieval, and record maintenance.
Ability to resolve billing and collection issues Disallows /Denials
Demonstrated ability to multiple-task and meet deadlines.
Computer skills, 10-key by touch, Data Entry
Centricity, EMR, EPIC, MaxMc, NaviMedix, ViWeb, Passport, LastWord, Ez-Cap
WORK EXPERIENCE
Collector Support Rep., Kaiser Permanente (01/09 – 02/10)
Conducted necessary investigation and appropriate late discovery for workers compensation matters involving claims for personal injury compensation. Gathers, analyzes and organizes information. Respond to patients written inquiries, bad debt review, contested charges for professional fees and hospital fees. Maintain accurate documentation of records on each case. Review patients’ chart, treatment history, and billing. Respond to interrogatories or discovery demands. Access California Workers’ Compensation Appeals Board case data. Complete all transactions needed by the Workers Comp Lien unit according to established timeframes and procedures. Patient Billing Resolution. Special projects as assigned.
Insurance Verification/Payment Poster, Lexcon (08/04 –08/08)
Ascertained patient account, demographic, and insurance information to be correct
And made any corrections, registered patients, verified insurance eligibility and benefits Verified workers compensation. Obtained pre-authorizations, referrals, and scheduled patients for clinical services. Witness patients signature consents. Responsible for assuring correct billing information is documented into the appropriate system(s) and communicating with patients to obtain any missing information. Minimized the reimbursement risks associated with providing care to patients. Posted insurance and Third Party Liability payments, collected co-pays and deductibles.
Election /Administrative Specialist I, King County/Records & Elections (09/06 – 06/07)
Performed a variety of duties to support administration of primary and general public elections. Answered incoming calls, provided election information to the public, public officials, and explained polling place operations and election process. Searched voter’s information using Data Information Management Systems, called voters to verify information; process voter registration requests, search voter’s records, updated voters demographic information, process incoming mail ballots including signature verification, envelope opening, and ballot inspection and reconcile poll books. Received and accounted for election materials and supplies delivered to election headquarters.
Intake Coordinator, Body of Christ Outreach Ministries (06/03 – 08/06)
Interviewed clients to obtain financial information and supporting documentation. Determined eligibility and program participation in accordance with procedures. Gathered client demographics, income, family size, employment history, and current assistance from other public assistance programs (TANIF). Prepared referrals for other community resources and social services available to clients. Responsible for a wide variety of complex and routine administrative support duties. Assisted clients with completion of application.
Utility Account Representative, City of Seattle (06/01 – 06/03)
Responded to a variety of request, complaints and inquiries from residential and commercial utility customers relating to all products and services offered by Seattle Public Utilities. Calculated and processed adjustments to customers account to correct late fee, returned check fees or misapplied payments. Performed queries in multiple databases. Opened and closed electric and water accounts for residential and commercial accounts. Resolved complex customer issues and disputes. Assisted customers with payment arrangements. Performed basic financial eligibility pre-screening customers for energy assistance and appropriately referred customers to the designated community agency. Updated customers billing information. Resolved customer disputes and service complaints.
General Accounting Clerk III, American Title Company (02/97 - 04/01)
Researched and defined problems with homeowner's escrow taxes, ground rent, irrigation bill and delinquent property taxes. Resolved discrepancies. Acted as liaison between homeowner's and taxing authorities. Responsible for determining financial liability for tax penalty claims. Requested check disbursement to various taxing jurisdictions. Ordered legal documents and property description, comprehended legal documents, rules, policies and procedures.
Instructional Teacher, Seattle Public Schools (01/93 - 01/97)
Planned an instructional language program to meet individual student’s needs.
Fostered a climate conducive to the learning and maturation process of students. Planned developmental appropriate activities following weekly themes. Evaluated and documented students progress. Prepared Individual Educational Program reports. Worked with Special Ed students. Held parent’s teacher consultations.
EDUCATION
Bachelor of Arts degree in Sociology
Associate of Applied Science degree in Business Technology Accounting
Chemical Dependency coursework
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