Danielle Norwood-

Address: *** ** ***** ******* *** 304 Pembroke Pines, FL 33025

Phone: 954-***-****

Email: adt16i@r.postjobfree.com

Core Strengths:

Strong ability in creating, implementing and teaching standards, policies, and procedures

Ability to quickly adapt to an environment

Ability to verbally communicate effectively with upper management and lower-level staff.

Strong interpersonal and written communication skills

Self-starter with the ability to work as a team member or independently.

Skilled at conflict resolutions and problem solving, proven ability to work in a fast pace environment

Employment:

10/07-Present Ereceivables Hollywood, FL

Billing/Operations Manger

-Monitored and supported staff for claims submitted via electronic clearinghouse and paper claims via mail.

- Resolve rejections based on front end edits, and payer rejections (Change Health Care)

- Reviewed 837 EDI error edits for IT updates.

- Managed lockbox batches for staff distribution and tracked daily cash deposits; resolved credit and debt errors related to returned checks to ensure daily deposits balanced

- Maintained Medicare provider enrollment renewals

- Research and resolved unapplied cash issues

-Trained staff for lock box retrieval and batching, cash posting, adjudication follow up, clearing house follow up, Commercial credit card processing.

- Posted insurance payments, denials and credit card payments submitted via lock box and phone.

- Supported patient contact and appeals department

- Negotiated settlements

-Maintained monthly SLA’s for – Cash posting, denial follow up, and unapplied cash

Appeals Team Lead-

- Analyze, research and resolve appeals requests through review of benefit design, eligibility, care management procedures and claim payments as they relate to the identified issue

- Communicate with departments to assure accurate and complete research to resolve appeal

- Research accounts for payments and adjustments to resolve appeals for closure

- Resubmit corrected claims UB04/1500 forms, medical records, proof of timely etc.

- Review appeal correspondence and explanation of payments

07/07-09/07 United Health Care Sunrise, FL

Inbound Customer Service

- Took inbound calls from providers for claim inquires, payments, and denials

- Provided medical benefits to members and providers

- Reviewed claims for discrepancies and submitted them for review

05/06-05/07 HHH Consulting Inc. Miami Lakes, FL

Medical Biller/Office Manager

- Submitted DME claims to Medicare with electronic transmission batches – Daily

- Reviewed and resubmitted office rejection reports

- Added and updated software with new and existing client’s information and specialty procedures

- Purchased office supplies and maintained inventory

- Processed and obtained credentialing applications for DME provider numbers

- Posted payments

08/05-04/06 Access Diabetic Supply Pompano Beach, FL

Insurance Verifier

- Verified patient eligibility and benefits; primary/secondary (all commercial lines of business and traditional Medicare

- Recorded detailed coverage benefits related to DME equipment request by patients

- Obtained authorizations for equipment if required

- Processed passport verifications

- Maintained daily, monthly and quarterly verification requirements

02/03-08/05 Nations Health Sunrise, FL

Team Leader

- Managed staff of 20, with daily operations; outbound calls for prescription completion.

- Trained new hires; with detail prescription requirements needed for DME supplies.

- Monitored staff attendance, and performance through Q&A procedure; using screen/audio share to review rep’s navigation and verbal competence.

- Handled supervisor request to resolve and support staff members.

- Assisted with recruitment and quarterly projects- to ensure quotes were met.

10/02-02/03 Complete Care Birth Center (Temp) N.M. Beach, FL

Medical Administrative Assistant

- Took urine samples

- Billed electronic CMS1500 claims to Medicaid and commercial health plans

- Scheduled/ followed up on appointments, verified benefits, requested pre-authorized for medical procedures

- Processed and obtained credentialing approval for commercial patients

05/01-08/02 Parkway Diagnostic Center N.M. Beach, FL

Patient Services

- Answered phones, greeted patients, collected copayments

- Possessed excellent customer service skills. Interacted with a wide range of patients, operations staff, and physicians

- Faxed electronic reports, verified walk-in benefits, prepared existing/new patient charts

- Registered diagnostic procedures

Education:

2015 Associate in Arts Degree Broward College Hollywood, FL

Computer Skills:

Windows 10

Microsoft Office, Word and Excel

Passport - (Insurance Verification) Soft Aid- (DME Billing System)

Eagle, CFO, I suite - (New York Hospital System)

Meditech, eHealth- (St. Mary’s Hospital System)

QMS- (Renal Advantage Dialysis System)

Sequoia, Siemens, CSC Papers Batch – (Scott and White Hospital System)

Epic (Ochsner Hospital – Piedmont Hospital)

SAP (Bioventus LLC)

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