Follow Up United States
Resume:
Joyce E Duplessie
WINLSOW, ME ***01 US
Mobile: 207-***-****
Email: ************@*******.***
Work Experience: Titan Health Management Solutions 2500 Pantano Road Tucson, AZ 85715
06/01/2021 – 10/04/2023
Payor Collection Specialist II
Duties, Accomplishments and Related Skills: Responsible for the timely collection (payment) of outstanding hospital claim balances related to claim underpayments or denials. Timely collection of appeals /grievances. Identify and resolve denials, including escalation appeals to higher level as appropriate. Supervisor: Samantha
Work Experience: Gainwell Technologies/DXC/Molina Healthcare 45 Commerce Drive Augusta, ME 04330 United States
11/2017 – 05/ 2021
Associate Representative, Provider Services
Duties, Accomplishments and Related Skills: Responsible for answering all calls from providers regarding claim issue, eligibility and benefits, provider credentialing and website assistance in a call center setter, Resolved calls within expected response time standards. Also answered and resolved calls from members.
Work Experience: Maine General Medical Center 10 Water Street Waterville, ME 04901 United States 03/2009 - 08/2017
Insurance Follow-up Representative
Duties, Accomplishments and Related Skills: Conducted follow up activities in relation to commercial and government payers for prompt reimbursement due the hospital. Analyzed rejected claims to determine cause of denial and initiate appropriate action to
claims. Communicated with hospital internal personnel, external organizations, and payer websites. Notified appropriate personnel of payer trends and issues. Member of the Peer Interview Team.
Work Experience
Kelly Service/Public Consulting Group (PCG)/MaineCare 442 Civic Center Drive Augusta, ME 04330
06/2008 - 03/2009
Interim Payment Recapture Collector & Research Assistant
Duties, Accomplishments and Related Skills: Performed research and resolved claim billing issues. Communicated to providers requesting additional documentation and information needed to resolve claim issues. Triaged Governor's and Commissioner's escalated Maine Care issues. Assisted Provider Relation Specialists in resolving claim issues and research as needed.
Work Experience
Jane Nelson Agency/Farm Family Insurance Main Street North Vassalboro, ME 04962
04/2007 - 05/2008
Customer Representative
Duties, Accomplishments and Related Skills: Serviced all billing inquiries, patient payments. Processed policy endorsements, quotes, cancellations, auto ID cards, insurance binders. Quoted new and renewal policies for commercial and personal auto, home, liability policies. Front person for all incoming and outgoing calls, walk-ins, Scheduled customer appointments for agent with all documentation needed for meetings.
Work Experience
Inland Hospital 200 Kennedy Memorial Drive, Waterville, ME 04901 United States
08/2001 - 03/2007
Patient Account Representative
Duties, Accomplishments and Related Skills: Performed Commercial, Government, Workers Compensation, Motor Vehicle and Liability claims. Reviewed remittances for accuracy and appeal any denials. Process contract-billing for one nursing home. Also, had stream-lined the billing process for this nursing home. Purchasing agent for the department, checking inventory and ordering supplies. Sorting all out-going hospital mail.
Education: KVCC Fairfield, ME United States Some College Coursework Completed Credits Earned: 67 Semester hours Major: Medical office field Relevant Coursework, Licenses and Certifications: Completed Medical Terminology, Anatomy & Physiology, ICD9 and CPT coding courses Additional Information: *Peer Interview Team *Completed six core classes & two electives that make up the Professional Development Program
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