Donna Douville

Insurance Verification

Spokane, WA 99207

adteek@r.postjobfree.com

+1-509-***-****

Looking for position that will utilize my skills, education. While giving me the opportunity to grow, and develop within company . Hard working, dedicated professional, wanting permanent position with opportunity to grow and learn.

Authorized to work in the US for any employer

Work Experience

Billing Specialist

Spectrum - Irving, TX

October 2021 to January 2022

• Assist customer in making payments

• Educating on billing cycle, due date

• Educate on products such as cable, streaming, internet upgrades and downgrades.

• Investigate missing payments

• Handle angry customers

• Took up to 100 calls per shift

Customer Service Representative/Call Center

CVS Health - Flower Mound, TX

April 2021 to July 2021

• Data entry

• enrolled patients into pharmacy benefits

• Processed claims

• Gathered insurance information up to three insurance companies

• Started prior authorizations

• Took up to 45 calls per shift

Member Service Specialist

Insight Global/ Molina - Irving, TX

November 2019 to April 2020

• Answered inbound calls about benefits

• Helped location Primary care, specialist, rides, dental, hearing, and vision providers

• educated patients about what was covered, what needed prior authorization

• Took up to 70 calls per shift

Insurance Verification Representative

Alliance RX - Irving, TX

April 2019 to September 2019

• Processed Pharmacy Benefit claims

• Researched alternatives, verified formulary,

• Verified Insurance, drug and quality

• Troubleshoot issues with insurance company

• Took up to 80 calls per day

Social Media Specialist

Volt Services / 247 inc

February 2018 to July 2018

• Addressed issues via Facebook and Twitter for AT&T

• Investigated

Customer Service/ Collections

I QOR - Plano, TX

September 2017 to 2018

• Took inbound calls and made outbound calls for retail credit cards

• Made collections, helped settle with customers

• Sent out new cards for disputes, fraud, and took payments

• Took unto 40 calls inbound and made up to 40 outbound Customer Routing Coordinator

SPECTRAFORCE/ SAFECO - Spokane, WA

April 2016 to August 2016

• Helped with billing of insurance and understanding it.

• Verified third party billing

• Educated customer about different payment options

• Helped route customer to correct department

Customer Service

QUALFON - Spokane, WA

August 2015 to December 2015

• Helped customer track packages

• Sized clothes for European auction

• Handled exchanges and refunds

• Educated customers on how Zulily works

Prior Authorization Representative

EXPRESS SCRIPTS - Spokane, WA

August 2014 to August 2015

• Processed insurance claims to get medications covered.

• Researched alternatives

• spoke with medical personnel about interactions and other options

• Had the ability to process up to 880 faxes

• monthly and meet production bonuses

Claims Processor

Sutherland global - Houston, TX

June 2022

process medicare, medicaid, children health claims for New York and New Jersey. Processing 280 claims weekly

Education

Associate of Science in Medical Billing and Coding ULTIMATE MEDICAL ACADEMY - Clearwater, FL

December 2013 to May 2015

Certificate in Call center Management Training

Spokane Falls Community College - Spokane, WA

June 1999 to June 2000

High school diploma or GED

Skills

• Customer Service (10+ years)

• problem solving (Less than 1 year)

• RECEPTIONIST (2 years)

• RETAIL SALES (2 years)

• Time management (10+ years)

• Health Insurance (3 years)

• Auto Insurance (1 year)

• Billing (3 years)

• claims (3 years)

• CPT (3 years)

• Customer Service Skills (10+ years)

• Scheduling

• EMR Systems (3 years)

• ICD-9 (2 years)

• Insurance Verification (3 years)

• Medical Billing (3 years)

• Medical Coding (3 years)

• Medical Records (3 years)

• ICD-10 (1 year)

• Medical Terminology (3 years)

• Cold Calling (2 years)

• Physiology Knowledge (3 years)

• Transcription (3 years)

• ICD Coding (3 years)

• Medical Office Experience

• Microsoft Office (6 years)

• Microsoft Excel (2 years)

• Microsoft Word (6 years)

• Microsoft Outlook (9 years)

• Anatomy Knowledge (3 years)

• Medical Scheduling (3 years)

• HIPAA (3 years)

• Data Entry (10+ years)

• Epic (1 year)

• CRM Software (4 years)

• Phone Etiquette (10+ years)

• English

• Managed care (2 years)

• Computer skills (10+ years)

• Word processing

• Computer literacy

• Search engines

• HCPCS

• Healthcare management

• NCQA standards

• CPT coding

• Medicare

• Customer support

• Documentation review

• Salesforce

• Typing

• EDI

• EDI

• Filing

• Windows

• Communication skills

• Analysis skills

• Zendesk

• 4G/LTE

• Patient monitoring

• VPN

• Writing skills

• Maintenance

• EHR systems

Certifications and Licenses

PTCB in Process

January 2021

Currently in processing of getting Certificated

Assessments

Verbal Communication — Proficient

August 2020

Speaking clearly, correctly, and concisely

Full results: Proficient

Customer Service Manager — Proficient

April 2020

Identifying and resolving common customer issues.

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

KEY COMPETENCIES

• Multi tasking

• Speaking

• Writing

• Customer Service

• Mathematics

• Time Management

• Judgment and Decision Making

• Active Learning

• Active Listening

• Service Orientation

• Persuasion

• Negotiation

• Critical Thinking

• Complex Problem Solving

• Troubleshooting

Contact this candidate