Customer Service Data Entry, Business Finance, Business Analsyt

Ronnie Wade Thorpe

Cary, NC ***** 919-***-**** ***********@*****.***

SUPERVISOR BUSINESS FINANCE

Reliable professional with diversified experience in Business Finance. Strengths include working well with others and having excellent communication skills. Collaborator and leader, motivated to perform quality work within the projected time frame. Seeking the opportunity to utilize educational background in finance and work experience in the Business & Healthcare industry. AREAS OF EXPERTISE

● Medical Terminology & Managed Care Contract: Proficient in medical terminology and capitation-based managed care agreements, including Medicaid contracts involving per-member, per-month payment models and provider-patient allocation.

● Customer Service & Communication: Extensive experience in delivering high-level customer service with strong interpersonal skills. Proficient in telephone protocols, professional email etiquette, and conflict resolution.

● Healthcare Administration & Compliance: Skilled in applying departmental policies and procedures for verifying patient information, managing records and documentation, and ensuring compliance with healthcare regulations.

● Leadership & Team Management: Experienced in situational leadership, team supervision, and staff development. Proven ability to lead teams, foster collaboration, and build productive relationships across departments and networks.

● Data Entry & Claims Processing: Expertise in accurate data entry (CRT), insurance and claims review, correction of edits, and revenue cycle management including coding and billing processes.

● Scheduling & Cash Management: Competent in coordinating patient appointments, managing clinical schedules, and overseeing cash handling procedures to ensure accuracy and accountability.

● HR & Staff Development: Skilled in recruiting, interviewing, hiring, and training clerical staff. Conduct performance evaluations and lead staff meetings to align team goals and performance standards.

● Healthcare Systems & Software: Duke Payroll System and other administrative platforms used in healthcare operations. TECHNICAL SKILLS

Microsoft Works, Lotus 1, 2, 3, Maestro Microsoft Office Blue-E IDX Search America MCIS Quicken SAP/GAP/MPV Paradox NC Tracks CMS/MARX Maces Amisys Wipro Epic Cadence PROFESSIONAL EXPERIENCE

UnitedHealthcare, Cary, NC April 2024 - May 2025

Benefits, Advocacy, E&I Customer Service

Provide exceptional customer service to clients in need of benefits assistance.

● Advocate for clients to ensure they receive proper benefits coverage.

● Handle a high volume of incoming calls and emails with professionalism.

● Collaborate with team members to problem-solve and find solutions for clients.

● Maintain accurate and detailed records of client interactions and resolutions.

● Demonstrate empathy and understanding towards clients in difficult situations.

● Proficient in using computer systems and databases to access client information.

● Stay up-to-date on company policies and procedures related to benefits advocacy. BCBSNC - Membership Specialist Professional 1 September 2022 - January 2023 Representative SMA Recon (Membership)

Managed, reconciled and corrected Medicare Advantage Plans (HMO, PPO, PDP), etc.& Railroad members' enrollments. Also, Medicare prescription drug plan's part D, and reviewed Medicare parts A & B during the enrollment period.

● Provider Enrollment - reviewed and corrected as needed, and sent follow-up letters as needed to members.

● Performed error output resolution for electronic eligibility processes error discrepancy lists. University of North Carolina at Chapel Hill Hospitals February 2020 - February 2021 Financial Navigator Urology Clinic

Generated Estimates at patients' request. Discussed billing issues and concerns with patients.

● Provided Cash Management, and collected pre-payments as well as co-payments and Co-insurance.

● Added Insurance and update Demographics.

● Offered payment plans if needed, also screened for Medicaid to see if the patient might qualify. Provided financial Assistance if the patient might qualify.

Ronnie Wade Thorpe 919-***-**** Page 2

Duke University Medical Center March 2003 - June 2019 Health System Medicaid Eligibility Analyst, April 2017 - June 2019 Coordinated and facilitated the Medicaid application process across multidisciplinary entities to obtain Medicaid Eligibility for patients entitled to Medicaid to attain reimbursement for services provided by Duke University Health system.

● Conducted thorough, in depth interviews and evaluate patients’ case for potential eligibility for Medical Assistance Programs and any applicable Purchase of Medical Care programs.

● Communicated and advised patients on complex financial concepts and procedures of applying for Medicaid *Follow up with patient and the Department of.

● Social Services to ensure all pertinent information has been provided relevant to the Medicaid application.

● Travelled to patient’s residency to transport the patient to the Department of Social Services for follow-up visits obtaining additional records, and verify or correcting information on behalf of the patient.

● Anticipated and troubleshot logistic and compliance barriers.

● Evaluated case files to determine issues and sufficiency of evidence or documentation, analyzing Social Security Administration.

● Created Rules, Division of Medical Assistance guidelines, and relevant regulations for applicability.

● Prepared hearing briefs, assemble documentary evidence and exhibits to represent the patient at local agency, State, and Chief Hearing Officer hearing s for the purpose of reversing a negative with or without the patients’ assistance. Duke Otolaryngology of Raleigh (ENT - CPDC) Service Access Team Lead, March 2013 - October 2017 Supervised front desk staff (clerical staff). Helped cover front desk as needed with check-in and check-out.

● Scheduled follow-up appointments and any tests ordered, CT, MRI, etc.

● Got authorizations, monitoring, collecting co-pays and out-standing balances.

● Monitored and updated the patients on wait times in the waiting room.

● Scheduled monthly staff meetings.

● Ran monthly Crystal Reports on copay-collections, CT Scans, Performance Reviews-errors etc.

● Cash Management - Collect bank deposit for the clinics in the hold building and sign off to Loomis at pickup.

● Made sure the FCC and the PSA’S attend the FCC and PSA meetings.

● Advised and train on updates in Maestro.

● Approved time cards and approve time off.

● Interviewed and hired New Staff.

● Worked with Providers on blocking and unblocking schedules as needed also corrected and entered charges through (charge entry) - add-on appointments.

● Made Charge Review Edits and ran estimates as needed per providers/patient request. Duke Urology of Raleigh (CPDC) Financial Care Counselor, July 2011 - March 2013 Verified and updated Insurance information through IDX, Blue-e, & MPV. Call Insurance Company’s. Clear all Alerts and Bill holds. Worked and cleared edits. Collected copay's at check-in Verify and update all Patients demographic information at the time of Registration.

● Advised Self pay patients of the charges for their procedures and there responsibility.

● Advised and discussed outstanding balances with patients. Discussed discounts.

● Assisted PSA’S and other staff member with billing questions, system issues and updating patient’s information.

● Looked up patients records through browser. Scheduled appointments and set up Diagnostic Imaging Scans CT, Ultrasound, etc.

● Obtained Authorizations, linked Referrals to appointments.

● Provided Cash Management, End of the day Batch out and verified cash bag.

● Kept up with all updates to IDX, Blue-e, & MPV. In this position, the providers often asked what their reimbursement on vasectomy and other procedures is etc., for patients who had Medicaid. They were aware of the Capitation contracts and agreements. Advised the providers of their reimbursement and the contractual adjustments. The providers agreed to accept assignment for a certain number of patients per month so that they would see who had Medicaid. They were also aware that we could not balance bill a Medicaid patient. The contract was decided on during the provider enrollment period. Discussed the number of Medicaid patients that were seen monthly in the monthly meetings, keeping track of the number of patients that were agreed upon to see, and keeping track of the reimbursement. Ran estimates off the procedure codes and modifiers based on the provider's orders, coding, and dictation notes. Ronnie Wade Thorpe 919-***-**** Page 3

Duke University Medical Center Financial Care Counselor, April 2009 - July 2011 Managed Main Registration, and verified patients demographic information and insurance.

● Verified appointments. Set up appointments, Labs, Pre-ops, surgery accounts Dx codes/ ICD-9S Collected co-payments, deductibles, co-insurance, and any unpaid balances.

● Had ABN ran on walk-in Medicare patient with the procedure and Dx codes to see if Medicare will make payment.

● Got Consent forms signed. Checked and prepared all surgery paper making sure they all have the Doctors names and correct codes before the departments picked them up.

United Parcel Service Revenue Auditor, March 2003 - March 2009 Ensured customers paid according to UPS rules and guidelines

● Made charge corrections and adjustments if needed. ADDITIONAL RELEVANT EXPERIENCE

University of North Carolina Hospital

Patient Accounting Representative

Tar Heel Temp UNC Diabetes Care Center

Tar Heel Temp Administrative Assistant

Tar Heel Temp Revenue Accounting

Duke University Medical Center

Special Account Representative Senior

EDUCATION

Master of Science & Leadership January 2018 - Present Pfeiffer University, Charlotte, NC

Master of Business Administration January 2018 - May 2021 Pfeiffer University, Charlotte, NC

Bachelor of Business Management & Leadership August 2013 - 2016 Pfeiffer University, Charlotte, NC

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