Billing Specialist Scheduling

KAREN KOWANICK

Scranton, PA *****

570-***-**** - adxtdb@r.postjobfree.com

PROFESSIONAL SUMMARY

Dedicated Appeals and Grievance Coordinator offering more than 5 years of experience assisting with collective bargaining, including resolving conflicts and mediating talks. Persuasive negotiator, talented organizer and complex problem-solver. SKILLS

Administrative Support

Customer Interaction

Financial Records

Appeals Support

ICD-10 PCS

ICD-10

Claims Adjudication

Grievance Resolution

Billing Procedures

WORK HISTORY

Appeals and Grievances Coordinator

Monumental Life Insurance – Moosic, PA

Master appeal and grievance regulations for Medicare and Medicaid policies. Ensure all processes are in adherences with CMS guidelines. Validate compliance with contracts, federal and state law. Completion of cases in specified timeframes as required by Federal regulations.

Investigation of all relevant information and prepare notification process. Communicate with members to obtain pertinent information. Used independent judgement and informed decisions to determine appropriate actions as it relates to each appeal and grievance.

02/2017 to 03/2023 Scheduling Specialist II

Geisinger – 52 Glenmaura Avenue Moosic PA 18507

Completes all appointment scheduling and cancellations. Coordinate and complete registration, demographic and insurance information cross trained in all 3 coverage areas.

Provided one call resolution whenever possible

Assist with training initiatives for new hires.

Maintain quality and service goals related to centers metrics 11/2015 to 05/2016 Billing Specialist

Xerox – Moosic, PA

Handled account payments and provided information regarding outstanding balances.

Worked with multiple departments to check proper billing information. Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.

09/1998 to 10/2007 Implementation Specialist

TMG Health – Jessup, PA

Identified discrepancies to devise and initiate cost-effective solutions. Broke down and evaluated user problems, using test scripts, personal expertise, and probing questions.

Explained complex, technology-related issues in basic, understandable terms to clients.

Configured hardware, devices, and software to set up work stations for employees. Installed and configured operating systems and applications. Helped streamline repair processes and update procedures for support action consistency.

EDUCATION

05/1995 Associate of Science: Human Services

Lackawanna College - Scranton, PA

05/1992 High School Diploma

West Scranton High School - Scranton, PA

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