Collection, customer service, call center, phone calls, multiple sya.

MONICA FLEMING

Nashville, TN

**************@*****.***

Authorized to work in the US for any employer

Insurance Follow-up Representative

Medix - Hendersonville, TN

December 2018 to Present

Follow up with insurance companies on denied dialysis claims

• Collect payment on outstanding dialysis claims for Managed Medicare, Commercial, and Managed Medicaid policies.

• Verifies insurance benefits, analyze EOBs and determine the steps necessary to correct claims submissions, rejections, denials, appeals & follow up

• Assures all contractual adjustments are correct prior to making collection calls

• Submits necessary request for medical records, completion of additional information, etc. as requested by insurance companies.

Insurance Follow-up Representative

CHS - Antioch, TN

January 2016 to December 2018

Worked denied hospital claims off UBO-4 forms

● Accessed each account for balance accuracy, payer plan and financial class accuracy, billing accuracy, and denials

● Collected payment on outstanding hospital claims

● Reviewed unpaid and underpaid claims

● Noted any updated account information into databases

● Utilized computerized billing software such as Artiva, Athena, and HMS

● Interpreted UB-04's and EOBs provided by SSI

Team Lead

CVS Caremark - Nashville, TN

January 2011 to October 2015

• Took inbound calls from Medicare Part D members

• Supervised and provided training for new hire employees

• Answered questions from team members, provided information, and processed eligibility enrollments

• Contacted the pharmacy on a constant basis, discussed EOB's

• Maintained call center performance metrics

• Effectively communicated information between management and team members in an open and timely manner

• Resolved escalated call and provided members with appropriate solutions and alternative resolutions to ensure resolution. WORK EXPERIENCE

Bachelor's degree in Computer Information Technology Trevecca Nazarene University

August 2016 to May 2020

Health Insurance

Customer Service

EDUCATION

SKILLS

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