Data Entry

Darbi Wortman

************@*******.*** - LinkedIn Profile – 520-***-****

An experienced Financial Services Manager and health industry manager with extensive hands-on experience with the following:

Commercial billing (BCBS, Cigna, Ambetter, UHC, Third Party Insurances

Government billing (VA, Tricare, Workers Comp)

Accounts Payable

Medicare/Medicare Replacement /Medicaid

Appeals

Training development

Training delivery

People management

Project management

Procurement

Led monthly calibrations for 5-20 staff members

Call center management

Inventory management

Experience

Northern Cochise Community Hospital (Apr 2018 – Current)

Patient Financial Service Manager

Manage Patient Financial Service Manager performing management duties for the Critical Access Hospital and Rural Health Clinic Visits. Duties included, but were not limited to:

Developing and delivering training program for CAH/RHC new hire and uptraining to Patient Service Representatives, Clinic Registration Representatives, Patient Financial Service Representatives.

Managed 11 to 15 staff members between registration and billing/scheduling coverage

Provides coaching staff 1:1 on performance and training opportunities, A/R review, insurance contracts

Coordinates special projects and staff-to-work ratios

Audited registered accounts for accuracy

Audited billed accounts for coding, billing accuracy

Audited state report and processed corrections

Submitting claims, reviewing coding issues, submitting appeals for patients due to insurance denials.

Posting payments, submitting refunds (patient and insurance)

Assisting case management with initiating inpatient authorizations and obtaining medical records to fully process authorizations and preparing appeals for medical necessity denials.

Pulling daily insurance payments for data entry.

First point of contact with patients, greeting and registering patients in an efficient and friendly manner.

Obtaining insurance information per NCCH protocol and verifying insurance eligibility via online or by phone based on eligibility systems. Initiating authorizations and notification to insurance for inpatient/outpatient transfer care.

Scheduling patients for MRI/CT/US/Dexa/Mammograms and proactively seeking referrals and prior authorizations if needed.

Accounts payable

Key Achievements:

Promoted to Biller from Registration staff within 1 year, Billing Lead for NCCH within 2 years of joining the team. Within, 3 years was promoted from Billing Lead to Patient Financial Service Manager over Billing and Patient Registration.

Created a training program for Patient Registration for CAH/RHC as well as the billing department.

Aridus Wine Company (Jun 2017 – Apr 2018)

Office Manager

Effectively communicated via email, telephone and in person to ensure great customer service and retention prevention. Focused on data entry, prepared correspondence, accounting and financial documents. Planned and coordinated all quarterly shipments and online orders. Liaising between the customers, point of sale and company executives, managed complaints, reviewed and provided comments on the adequacy of documents and took necessary steps to cure any deficiencies/handle complaints. Completed all company insurance renewals including property, Workers’ Compensations, general liability, and shipping. Monitored multiple databases to keep track of company inventory.

Optum/United Health Care Group (Nov 2013 – Aug 2016)

Operations Manager

Managed a sales call center floor with over 172 agents, managed supervisors and agents to reach goals. Managed agents on outbound campaigns to ensure consumer satisfaction. Worked closely with UHC to ensure a successful Sales training roll out and AEP season. Managed supervisors in coaching agents on selling Medicare Advantage, Prescription Drug Plans, Group Retiree Medicare Plans, and Medicare Supplement Plans.

Trained Optum Leadership Training to 17 Team Leads and Supervisors. Led calibrations with 5-10 agents for additional training, reviewing quality and selling techniques. Managed Phoenix Optum #1 sales site within Optum. Managed employee time-keeping to ensure payroll was correct prior to approval. Managed with Workforce Management Department for scheduling. Managed transitioning agents from one account to another within the call center.

Key Achievements:

Promoted to Operations Manager for M&R Group Sales within 2 years of joining the Sales department.

Promoted from a call center agent to a supervisor within 2 months of starting as an agent. Successful completion of C.O.I (college of insurance) training.

Successful completion of AZ State Health Insurance License. Obtained AZ Resident Health Insurance License. Obtained all 49 states Non-Resident Health Insurance License.

Within two (2) months of working for Optum, I was promoted from a call center agent, to a Supervisor for CVS Caremark.

Within four (4) months of receiving the supervisor promotion, I was licensed to sell Medicare and Retirement Insurance Plans and transitioned to a UHC Sales Supervisor.

Successful completion of UnitedHealth Care Medicare & Retirement Individual, Group Retiree and Medicare Supplement training.

Boart Longyear (Oct 2012 – Jun 2013)

Project Manager/Procurement Officer

Project Manager for E&I drilling for 7 national drill sites, including deployment and demobilizing of site. Prepared, ordered and corresponded shipments with over thirty (30) vendors for parts. Managed inventory, ordering, receiving and shipping. Provided financial support for over 50 drillers and field mechanics with credit card billing records, p-cards and employee reimbursement. Managed accurate records of over $100,000 of inventory. Created weekly disbursements for 13 different drill sites, and confirmed shipment receipts. Ensured with AP departments vendors were paid in a timely manner as well as checking for any discrepancies. Picked up and dropped off shipments from the distribution center when necessary. Key Achievements:

• Promoted within 3 months of starting to a Project Manager for E&I division. Successful launch of over 15 start up and demobilization of E&I Sonic Drilling; product ordering, setting up a portion of the warehouse and keeping inventory. OSHA/MSHA/CPR and forklift certified

Certifications/Licenses

Pending CBP certification exam (Schooling through AAPC)

Training

AAPC Online Program

Software Knowledge

Working knowledge of MS Office including Word, PowerPoint and Excel, Medhost, SSI Clearing House

Contact this candidate