Gwendolyn D. Frieson

*** ****** * **** ** Circle

Oxford MS. 38655

404-***-****

PROFESSIONAL SUMMARY

Healthcare professional with over 16 years on experience working within the industry handling patient’s accounts while ensuring all information is verified for accuracy and prepared for the facilitation of services rendered

While currently working as a contract employee with Fresenius, documents accurate information within accounts and ensures all information is maintained while reviewing information dating back previous years

While working at Parallon/HCA, ensured all patient insurance, demographic and eligibility information was collected and entered into HER accurately and efficiently

As a Data Entry Specialist at The Little Clinic, verified insurance cards and entered patients’ personal information for the facilitation of the billing processes and created 300-325 claims daily

Verified patient demographics and inputted medical record coding results in a timely and accurate fashion into CMS while working at Optum Health Care

Knowledgeable of ICD-9/10, CPT Codes, HIPPA/OSHA Compliance, Citrix/ECW, Emdeon Meditech, PME, Artiva, Onbase, 1095–A form, the Affordable Care Act (ACA) as well as proficient in Microsoft Office Suite – MS Word, Excel, PowerPoint, Outlook, UNIX, Windows 98, 2000, XP, Vista, and Windows

Extensive experience in customer service facing environments with interpersonal skills and the ability to work both independently and collaboratively as necessary

Available to interview within 48 hours’ business days’ notice

PROFESSIONAL EXPERIENCE

Baptist Memorial Hospital-Oxford, MS.

Admissions Rep.Finance

10/2019-8/2022

Obtain accurate demographic, financial and clinical information and enter it into the computer system to create the medical and financial record

Ensure the data base integrity and facilitate claims are processed correctly

Apply financial screening guidelines to make sure proper procedures are followed

Greet patient, visitors, vendors, Doctors families and direct them on which way to go.

Answer the phone and direct calls to different departments in the hospital.

PROFESSIONAL EXPERIENCE

Parallon/HCA /Skyline Hospital

Patient Benefits Advisor

10/2015 - 04/2019

Ensured all patient insurance, demographic and eligibility information was collected and entered into HER accurately and efficiently

Reviewed patient’s medical records to get familiarized with patient’s condition

Verified commercial insurance benefits and to ensure appropriate signatures were obtained on required release of information forms

Screened each patient at bedside to determine eligibility for Medicaid, Social Security and/or VOC

Served as a liaison between the patient, hospital, and state agencies and documented progress notes to the patient's file and hospital EHR system

Worked with case management team to assist patient in obtaining necessary documentation

Obtained medical records, physician statements and all other documentation required for eligibility determination

Acquired all requirements to begin SSI or disability applications and completed and submitted applications on behalf of the patient

Initiated, maintained and documented correspondence between patient and state agency caseworkers to ensure timely processing of applications

Certified Application Counselor through Federal Health Insurance Marketplace 2016, 2017

Contract: Randstad Staffing OR Robert Half International Agency 10/2014-02/2015

Permanent: Cognosante 02/2015 – 10/2015

Fielded an average on 100-150 outbound calls daily to consumers and gathered information in order to complete their 1095-A forms and correction requests

Verified consumers demographic information and ensured information was entered in correctly to ensure forms were completed accurately

Used and interpreted various federal polices, regulations and systems in responding to consumer inquires, regarding their 1095-A

Completed complex applications for appeals, and handled terminations and escalations

Educated customers and Member Representatives on procedures, benefits and polices of Tenncare Medicaid

ComplexCare Solutions

Outreach Specialist/Customer Service

09/2013 – 10/2014

Responsible for contacting prospective health assessment and care management patients

Worked with a variety of commercial insurances including, Anthem BCBS, Medicare Advantage Members of Ohio, Vantage of Louisiana, and Cigna

Scheduled health assessment patients and maintained their schedules on behalf of the clinical providers and Nurse Practitioners

Responded to customers/patients inquires related to the program and the assessment as well as scheduled appointments

Updated schedules based on provider availability, and handled all cancellations

Optum Health Care (Contracted Robert Half International)

Data Entry Clerk

10/2010 – 09/2013

Verified patient demographics and inputted medical record coding results in a timely and accurate fashion into CMS

Acted as a liaison between Data Analytics and Coding Department to ensure quality assurance

Handled abstracted documentation requirements based on CMS guidelines for the internal coding team and ensured all documents adhered to requirements

Followed all policies and procedures to contribute to the efficiency of the department

EDUCATION

Oxford High School – Oxford, MS

High School Diploma

North West Community College – Oxford MS

1988-1989

Everest College- Norcross GA

2009-2010

Reference available upon request

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