billing medical field
Resume:
Tammy Woollard
***************@*****.***
Parkersburg, WV 26104
Education
Warren High School
August 1980-June 1984
General Diploma
Gpa 3.8
Experience
September 6,2022-Current
Everise
Outsource for Humana and Medicare/Medicaid
Skills
-Incoming calls taking billing issues and find the appropriate task to resolve the issues for the members billing issues:
-taking payments
-changing billing and payment methods
-filing for reimbursements
-overpayments
-Humana policy issues:
-coverage
-tier of medication coverages
-stages the member is currently in
-arranging for prescriptions to be sent thru Humana pharmacy Center well prescriptions and otc meds Resume:
2
-changing doctors via the member’s request
-finding primary care doctors to specialty doctors for member
-finding nearby pharmacies for member
-providing information on the insurance policy for providers of the members
-file appeals and grievances
-investigate claims for providers and members
-start claims for members
-call providers and pharmacies for members to get appointments and medications covered Programs:
-Word
-Spreadsheets
-Argus
-workday
-Nova RX
-RX call connect
-RX Pro
-Geneseys softphone
-GoBot2
-Litton
-CI
Took 7 weeks of training thru Everise and Humana. Accumulating 340 work hours in class with modules and test. Was elected one of the top two in my class of 42 students. Completed with a certificate.
March 2014-February 2022
MMH (Marietta Memorial Hospital)
Patient Financial Advocate
Skills:
-Coordinate communication between patients, family members, medical staff, administrative staff, or regulatory agencies.
-Maintain knowledge of community services and resources available to patients 3
-Investigate and direct patient inquiries or complaints to appropriate medical staff members and follow up to ensure satisfactory resolution.
-Develop and distribute newsletters, brochures, or other printed materials to share information with patients or medical staff.
-Analyze patients' abilities to pay to determine charges on a sliding scale.
-Meet with patients and family members requesting financial help appointments or hospital stays. - Help said patients to fill out applications and request necessary documents to prove household income. Finalized application with sliding scale and added discounts to all accts during the period of eligibility.
-Took payments by phone and in person. Corrected bills and accts of patients. Answered phone with billing issues if unable to correct issues would contact correct person to have issues handled. February 2005 - March 2014
East of Chicago Pizza
Marietta, Ohio
Manager
Skills:
-Monitor compliance with health and fire regulations regarding food preparation and serving and building maintenance in lodging and dining facilities.
-Monitor food preparation methods, portion sizes, and garnishing and presentation of food to ensure that food is prepared and presented in an acceptable manner.
-Count money and make bank deposits.
-Investigate and resolve complaints regarding food quality, service, or accommodations.
-Coordinate assignments of cooking personnel to ensure economical use of food and timely preparation.
-Schedule and receive food and beverage deliveries, checking delivery contents to verify product quality and quantity.
-Maintain food and equipment inventories and keep inventory records.
-Schedule staff hours and assign duties.
-Establish standards for personnel performance and customer service.
-Perform some food preparation or service tasks such as cooking, clearing tables, and serving food and drinks when necessary.
Resume:
4
-Plan menus and food utilization based on anticipated number of guests, nutritional value, palatability, popularity, and costs.
-Test cooked food by tasting and smelling it to ensure palatability and flavor conformity.
-Organize and direct worker training programs, resolve personnel problems, hire new staff, and evaluate employee performance in dining and lodging facilities.
-Assess staffing needs, and recruit staff using methods such as newspaper advertisements or attendance at job fairs.
-Record the number, type, and cost of items sold to determine which items may be unpopular or less profitable.
-Schedule use of facilities or catering services for events such as banquets or receptions and negotiate details of arrangements with clients.
-Create specialty dishes and develop recipes to be used in dining facilities.
-Take dining reservations
References Upon Request
Contact this candidate