Customer Service Follow Up
Resume:
Tammye Reddick
E-mail: ad2xhb@r.postjobfree.com
SUMMARY
Responsible for auditing incoming patient records entered into eIntake for accuracy and completeness for revenue recognition and collection. Managed patient accounts for documentation needs throughout life of account. Served the customers of the Support Center by performing tasks related to patient care and third party reimbursement. Received North Carolina Career Readiness Certification ACT Sponsored. SKILLS
Epic, Onbase, Artiva, One Soruce, Medicare IVR, Secret Server, Microsoft Word, Excel, Power Point, IMBS Patient Data base, eForms, Emdeon, NPI database, ICD 10 codes, prepare CMN and SOP’s, process ABN, BL401 forms for billing, Clarity report, Right Fax PROFESSIONAL EXPERIENCE
Parallon, Inc. Charlotte NC WFH - May 2017- present Insurance follow up representative
Process medical insurance accounts to address claim issues and to affect payment and/or bring account to a resolution. Research claim status with carries via various portals to reach resolution and payment of claims.
Update insurance plans for patients to rebill claims and process coordination of benefits. Work with insurance companies and completing any necessary correspondence to facilitate account resolution.
Manage Medicare, Medicaid, Managed Care Plan, BCBS, Cigna, and Untied Healthcare accounts. Communicate with Medicare and Medicaid IVR to check eligibility on patients, Worker Comp, Hospital Accounts, VA Tricare, Champ VA.
Submit insurance claims to individual insurance companies electronically or via paper form and process corrected claims. Review 1500 claims for accuracy and completeness and obtain missing information required for submission. Review and appeal paid and denied claims.
Analyze remittance advice to ensure accurate posting of rejections, contractual and timely filing adjustments. Submit billing review for CPT codes for coding issues.
Check claims for accuracy and compliance with contract spreadsheet. Check on providers credentialing issues thru NPPS Registry. Identify and bill secondary or tertiary insurance. Rotech Healthcare Inc. Charlotte, NC - January 2014 – April 2017 Patient Account Specialist
● Worked extensively with eIntake proprietary system, maintains accuracy and quality control throughout patient contact and data input for 60 month replacement on concentrators
● Received medical record documentation and provides through review and Quality Assurance for physician’s order, testing, progress notes, medical necessity and other documentation requirements for payers and regulatory bodies
● Audited file and proof of delivery documents to confirm products and services were provided as ordered and all data entered in eIntake is accurate. Resolves error by communicating and resolving with patient, referral sources.
● Verified the accuracy of the information in IMBS and eIntake compared to information on the required forms to create CMN
● Provided product/service information by answering questions, offering assistance
● Communicated any form errors to the store or makes necessary corrections in IMBS and eIntake, based on the information written on the form
● Followed successful QA, confirmed charges in eIntake for adjustments on patient
● Worked extensively with eIntake proprietary system, maintains accuracy and quality control throughout patient contact and data input to create CMN.
● Proactively obtained re-certifications, re-authorizations, renewal orders as required
● Provided timely resolution for accounts not in a payable status (e.g., held item and no charge).
● Reviewed future services and tasks needed for account review the NATs Needs Attention Tasks in eIntake
Charlotte Bobcats Basketball - Charlotte, NC - October 2008 – April 2015 Event Ticket Sales Agent
● Sold event tickets and club packages. Resolution of customer ticketing issues
● Maintained ticket tracking system Will Call and high volume cash handling with daily balance
● Performed various administrative tasks
● Maintained relationship with season ticket holders and corporate sponsors Creative Catering - Charlotte, NC July 2004 to April 2016 (Part-time) Event Coordinator
● Created supply list and managed invoice of supplies for all events Tammye Reddick E-mail: ad2xhb@r.postjobfree.com
SUMMARY
Responsible for auditing incoming patient records entered into eIntake for accuracy and completeness for revenue recognition and collection. Managed patient accounts for documentation needs throughout life of account. Served the customers of the Support Center by performing tasks related to patient care and third party reimbursement. Received North Carolina Career Readiness Certification ACT Sponsored. SKILLS
Epic, Onbase, Artiva, One Soruce, Medicare IVR, Secret Server, Microsoft Word, Excel, Power Point, IMBS Patient Data base, eForms, Emdeon, NPI database, ICD 10 codes, prepare CMN and SOP’s, process ABN, BL401 forms for billing, PROFESSIONAL EXPERIENCE
Parallon, Inc. Charlotte NC - May 2017- present
Insurance follow up representative
Process medical insurance accounts to address claim issues and to affect payment and/or bring account to a resolution. Research claim status with carries via various portals to reach resolution and payment of claims.
Update insurance plans for patients to rebill claims and process coordination of benefits. Work with insurance companies and completing any necessary correspondence to facilitate account resolution.
Manage Medicare, Medicaid, Managed Care Plan, BCBS, Cigna, and Untied Healthcare accounts. Communicate with Medicare and Medicaid IVR to check eligibility on patients, Worker Comp, Hospital Accounts.
Submit insurance claims to individual insurance companies electronically or via paper form and process corrected claims. Review 1500 claims for accuracy and completeness and obtain missing information required for submission. Review and appeal paid and denied claims.
Analyze remittance advice to ensure accurate posting of rejections, contractual and timely filing adjustments. Submit billing review for CPT codes for coding issues.
Check claims for accuracy and compliance with contract spreadsheet. Check on providers credentialing issues thru NPPS Registry. Identify and bill secondary or tertiary insurance. Rotech Healthcare Inc. Charlotte, NC - January 2014 – April 2017 Patient Account Specialist
● Worked extensively with eIntake proprietary system, maintains accuracy and quality control throughout patient contact and data input for 60 month replacement on concentrators
● Received medical record documentation and provides through review and Quality Assurance for physician’s order, testing, progress notes, medical necessity and other documentation requirements for payers and regulatory bodies
● Audited file and proof of delivery documents to confirm products and services were provided as ordered and all data entered in eIntake is accurate. Resolves error by communicating and resolving with patient, referral sources.
● Verified the accuracy of the information in IMBS and eIntake compared to information on the required forms to create CMN
● Provided product/service information by answering questions, offering assistance
● Communicated any form errors to the store or makes necessary corrections in IMBS and eIntake, based on the information written on the form
● Followed successful QA, confirmed charges in eIntake for adjustments on patient
● Worked extensively with eIntake proprietary system, maintains accuracy and quality control throughout patient contact and data input to create CMN.
● Proactively obtained re-certifications, re-authorizations, renewal orders as required
● Provided timely resolution for accounts not in a payable status (e.g., held item and no charge).
● Reviewed future services and tasks needed for account review the NATs Needs Attention Tasks in eIntake
Charlotte Bobcats Basketball - Charlotte, NC - October 2008 – April 2015 Event Ticket Sales Agent
● Sold event tickets and club packages. Resolution of customer ticketing issues
● Maintained ticket tracking system Will Call and high volume cash handling with daily balance
● Performed various administrative tasks
● Maintained relationship with season ticket holders and corporate sponsors Creative Catering - Charlotte, NC July 2004 to April 2016 (Part-time) Event Coordinator
● Created supply list and managed invoice of supplies for all events
● Arranged event staffing needs for deliveries and pick-ups
● Maintained customer relations for future events or referrals
● Performed various administrative tasks
Verizon - New York, NY December 1986 – December 2001 Customer Service Representative
Residential Department (1986-1991)
● Processed orders for new telephone service and customers telephone change requests.
● Processed customer relocations and changed names on accounts.
● Scheduled installation dates.
● Upsold phone features that required quotas.
Billing Department (1991-2001)
● High volume of incoming calls in queue regarding business accounts and necessary resolutions
● Processed payment arrangements, posted payments, collection referrals
● Personal billing representative for major corporate accounts: Viacom, Reuters, NBC, Inc. EDUCATION
Capella University - Bachelor of Science - Human Resource Management, June 2015
LaGuardia Community College - Associate Applied Science, October 1984
● Arranged event staffing needs for deliveries and pick-ups
● Maintained customer relations for future events or referrals
● Performed various administrative tasks
Verizon - New York, NY December 1986 – December 2001 Customer Service Representative
Residential Department (1986-1991)
● Processed orders for new telephone service and customers telephone change requests.
● Processed customer relocations and changed names on accounts.
● Scheduled installation dates.
● Upsold phone features that required quotas.
Billing Department (1991-2001)
● High volume of incoming calls in queue regarding business accounts and necessary resolutions
● Processed payment arrangements, posted payments, collection referrals
● Personal billing representative for major corporate accounts: Viacom, Reuters, NBC, Inc. EDUCATION
Capella University - Bachelor of Science - Human Resource Management, June 2015
LaGuardia Community College - Associate Applied Science, October 1984
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