Insurance Follow-Up Customer Service
Resume:
Dorothy ELY-Mc Bride
Jacksonville, FL *****
************@*****.***
Also can be reach through my email address if unable to reach me by phone Authorized to work in the US for any employer
Work Experience
Insurance Follow-up Specialist
Cancer Specialists of North Florida-Jacksonville, FL January 2023 to October 2023
Called insurance company on denied claims to see why they did not pay and resubmit corrected claims appeals and reconsideration
Insurance Follow-up Representative
Southeast Orthopedic Specialists-Jacksonville, FL
March 2022 to October 2022
Billing invoices, arranging payment methods, overseeing collections, accounts receivables and proper financial statements, authorizing patients prior to service,determine patient eligibility and benefits, submitting claims, dealing with posted payments and managing denials, reconsiderations and appeals Revenue Cycle Specialist
Baptist Home Health Care-Jacksonville, FL
February 2021 to December 2021
Billing invoices, arranging payment methods, overseeing collections, accounts receivables and proper financial statements, authorizing patients prior to service,determine patient eligibility and benefits, submitting claims, dealing with posted payments and managing denials, reconsiderations and appeals Medical Billing Specialist
Tambolina Services inc-Jacksonville, FL
June 2019 to February 2021
Schedule caregivers to clients and did the billing for Humana, Sunshine,United Healthcare,and We'll are Insurances
Accounting Clerk
Landstar Logistics-Jacksonville, FL
October 2018 to January 2021
Processed payment request on freight bills, add the freight bills to the claims, filled freight bills until all paper work has been entered into the billing system Premium Billing Consultant
Aetna-Jacksonville, FL
January 2017 to December 2017
•Collect and entering claim information.
•Post insurance and patients and manage accounts.
•Submit claims and following up with insurance carriers claims.
•Answer patient inquires on account status and charges.
•Typically reports to billing supervisor or provider office manager. Customer Service Representative
InComm
January 2015 to March 2015
Responsibilities
took calls from customers regarding their prepaid gift cards. researched their transactions,activated and deactivated their cards.
Customer Service Rep
Yes Energy Management-Jacksonville, FL
September 2013 to April 2014
Received inbound calls from residents calling on their utility bills Unit Clerk
St Vincent Healthcare-Jacksonville, FL
April 2012 to April 2013
Prepares and compiles records in nursing unit of hospital or medical facility: Records name of patient, address, and name of attending physician to prepare medical records on new patients. Copies information, such as patient's from nurses' records onto patient's medical records. Records information, such as physicians' orders and instructions, dietary requirements, and medication information, on patient charts and medical records. Keeps file of medical records on patients in unit. Prepares notice of patient's discharge to inform business office. Requisitions supplies designated by nursing staff. Answers telephone and intercom calls and provides information or relays messages to patients and medical staff.
Directs visitors to patients' rooms.
Compiles census of patients.
May keep record of absences and hours worked by unit personnel. May transport patients in wheelchair or conveyance to locations within facility. May key patient information into computer.
Provider Associate
First Coast Service Options
October 2010 to February 2012
Inbound call from provider's inquiring about claims that have been denied adjustments, over-payments, Accounts Receivable and Account Payable also Provider enrollment
Internship
Comcast
January 2010 to August 2010
Collections Rep
Wachovia Jacksonville
August 2009 to December 2009
Contact clients on overdue accounts that are over 90-120 days past due also work with them to make payment arrangements, or offer them programs that may help with their payments or interest rates Bankruptcy Processor
Sterling Healthcare-Jacksonville, FL
March 2009 to May 2009
Posted the bankruptcies to the account to stop collection calls, Account Receivables Collections Rep
Citigroup-Jacksonville, FL
April 2008 to August 2008
Contacted clients on late stage Accounts that were overdue to see if a payment could be made on the account or a
payment arrangement could be made before account went to collections Health Benefits Advisor
Maximus, Inc-Boston, MA
June 2003 to September 2007
Customer Service for the Massachusetts Medicaid Program Assist Providers with Claims that were billed incorrectly Helped resolve billing issues for members, Send out provider enrollment forms, Checked procedures and diagnosis codes verified that the providers were Mass Health Providers Appointment Scheduler
Miracle Ear, Inc-Orlando, FL
March 2001 to June 2002
Outreached customers to schedule hearing
Customer Service/Cashier
Mears Transportation-Orlando, FL
August 1998 to June 2000
Inbound and outbound drivers registration, Record drivers shifts data entry of wages and money owed to the company and drivers took in the receipts from the drivers and recorded it into the system Customer Service/Claims Representative
John Hancock Insurance Co-Boston, MA
November 1985 to January 1995
Created policies from insurance applications, was responsible for all applications for the Southern Regions.Outreached clients if additional information was needed for applications approval, also assisted agents in completing the applications the same day Education
High school diploma in Medical billing and coding
Concorde Career Institute has given me the understanding - Jacksonville, FL September 2008 to June 2009
High school diploma in Business
Hyde Park High School - Boston, MA
September 1978 to June 1981
Skills
• Peoplesoft (9 years)
• Cerner (10+ years)
• Teamcenter
• Epic (5 years)
• Powerchart
• Accounts Payable (5 years)
• Accounting (4 years)
• CPT Coding
• Medical Billing
• Medical Coding
• Physiology Knowledge
• ICD-9
• Anatomy Knowledge
• ICD-10
• Medical Terminology
• Medical Scheduling
• HIPAA
• Medical records
• EMR Systems
• Insurance Verification
• Clerical Experience
• Customer service
• Medicare
• Typing
Certifications and Licenses
Medical Coding Certification
Assessments
Customer service — Completed
October 2020
Identifying and resolving common customer issues
Full results: Completed
Work motivation — Proficient
June 2020
Level of motivation and discipline applied toward work Full results: Proficient
Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
Additional Information
QUALIFICATIONS:
Medical Terminology Customer Service CPT Coding
Anatomy and Physiology DME and Dental Coding HCPCS Medical Manager Word Processing MS Word 2000
First Aid CPR and AED Medical Office Procedures
Medical Ethic and Laws Scheduling OSHA and Infection Control ICD-9(volumes 1, 2, &3) Keyboarding Insurance Billing Medical Records Management Claims Processing Tricare and ChampVa Workmen's Comp Electronic Medical Records SMS software
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