Accounts Receivable / Accounts Receivable

Dana Rachelle Heaven **** Dardy St. Kansas City, KS 66101

Cell: 214-***-**** ***********@*****.***

QUALIFICATIONS

Proactive, detail-oriented, Professional Specialist in the insurance industry (claims, adjustments, reconciliations, Finance, and network management liaison to name a few). Trainer and coach with sound analytical and proven problem-solving skills. Capacity to take on increasing responsibility and assume multiple tasks. Demonstrated ability to think and plan strategically. Excellent accounts receivable skills, analytical skills, customer service, communication and interpersonal skills, team player, leader and technically proficient in Microsoft Windows, Outlook, Microsoft Excel, Microsoft Word, NDB, Access and PowerPoint. I am also a Mentor for the Juvenile Diabetes Research Foundation (where I speak at Health Fair and I mentor families where themselves or a close family member has recently been diagnosed with Type 1 Diabetes), a member of the Speakers Bureau for the American Diabetes Association (where I go out to speak and volunteer at Health Fair or at Cooperation and I am also a member of Toastmasters.

Career Focus

To contribute my analytical and problem-solving skills, along with my vast knowledge and experience to an advanced position within UHC.

Wanrack

Overland Park, KS

Accounts Receivable/Accounts Receivable

Dec 2023 – 11/2024

Process involves customer onboarding, invoicing, collections, deductions, exception management, and finally, cash posting after the payment is collected.

Tracking and recording all incoming payments from customers

Following up on unpaid invoices and late payments

Reconciling customer accounts and resolving discrepancies

Generating and sending invoices to customers

Processing credit memos and refunds

Researching and resolving account discrepancies

Maintaining records regarding payments and account statuses

Tracking overdue invoices and following up on them

Managing invoicing, payment collections, cash application, deductions, and credit risk

WebTPA, Inc

Irving, TX

Finance Associate / Treasury Operations Analyst

April 2017 – November 2023

Under limited supervision, this position handles all client account bank reconciliation, premium reconciliation, and client funding functions.

Pull financial data and generate reports to include cash reports, banking reports, and accounts receivable reports. Review and audit transactions to include cash, wires, ACH, and credit card.

Process authorized payments.

Analyze accounts receivable reports for trends and analysis.

Assist in forecasting and budgeting, month end close, as well as monthly invoicing.

Processes all client account bank reconciliation and premium reconciliation.

Processes bank and vendor set-up forms.

Premium reconciliation duties include applying premiums to subscribers and successfully resolving discrepancy dollars.

Worked with IT to streamline current job processes to enhance efficiency.

In addition to Finance, I also handle the following: apart of Web TPA Mentorship program to help create and implement new processes for organizational growth; Part of Web TPA booster committee working with HR to plan company functions and organize charity drives.

Create accounts receivable payment schedules, process schedules into physical checks and ACH payments.

Balance the checks and ACH payment registers, check for errors.

Print checks and process for mailing; including any special handling needs.

Negotiate with vendors for credits and resolve past due accounts.

Produce a variety of financial reports, examples; Check for Duplicate payments, Vendor monthly totals.

Research monthly vendor statements and any aged invoice trial balances.

Employed with United Healthcare Mar 2002 - Mar. 2017 Plano, TX

Market Service Agent

Serve as an issue liaison cross-functional coordination typically including the RRE, CPM, Contact Investigation, Network Management, Customer Service, Pre-certification Department, Stop Loss, Appeals Department and other UHG service units. Serve as point of contact for UHG centralized service/operational units and its external business partner.

Provide service accurately, completely or timely, by escalating and initiating expedited resolution actions within the service model, monitors resolution progress, and establishes regular communication with the provider until complete resolution is achieved.

Contact all parties related to the claims issue to reach the correct Resolution according to all signed contractual agreements. Reach out to all internal and external partners to determine exactly what is needed for proper Resolution with providers while inquiring about overpayment and underpayments.

Maintain a professional relationship with all clients. Perform all duties needed while following the guidelines of HIPPA.

Senior Claims Representative

(Reconciliation /Adjustment Specialist, Optum RX, Network Management Liaison)

Reconciliation / Adjustment Specialist

Provide expertise and general claims support to teams in reviewing, researching, negotiating, processing and adjusting claims.

Authorize appropriate payment or refer claims to investigators for further review.

Conduct data entry and re-work.

Analyze accounts receivable and identify trends and provides reports as necessary in order to determine root causes.

Consistently meet established productivity, schedule adherence, and quality standards

Resolve member questions relating to claims issues such as EOB’s (explanation of benefits

Respond to claims appeal when needed.

Provide effective communication feedback to the vendors and to the providers.

Ability to cross task, multitask several functions.

Must have strong thinking skills and the ability to work alone.

Ability to communicate with several vendors, review contracts to determine set up issues due to a root cause that is causing UHC and the vendor not to be in sync.

United Healthcare Plano, TX

Medical Claims Processor

Processed an average of 225-300 claims daily.

Education Associate Degree Philander Smith College August 1990 - May 1993

High School Diploma Hall High School May 1990

References

Sharon Scott 972-***-**** Former Manager – United Healthcare

Wanda Lee 214-***-**** Toastmaster Mentor

Tina Thomas 214 489 – 2960 Former Manager

Sharie Wilson 708-***-**** Former Supervisor

Contact this candidate