Gloria Scott-Calvin

*** ****** *****

Columbus,Ga 31906

706-***-****(c)770-***-****

w7m1hi@r.postjobfree.com

A highly skilled health care professional experienced in all phases of Medical Office,including HR, front desk admin. and back office.

Multi task and goal oriented, great team player with a verifiable record of success in payment posting, medical billing, collections and insurance follow up. 7+ years of health care call center experience, good work ethics and a willingness to learn.

AREAS OF EXPERTISE

Insurance Billing

Prompt Follow-Up

Detail-Oriented

Knowledge of CPT, ICD-9 Coding

Medical Terminology

Excellent Customer Service

HR Screenings/Interviewing

Superior Communication Skills (written & verbal)

Goal and task oriented

Back Office skills,injection,labs,etc.

PROFESSIONAL HISTORY

Riverchase Internal Medicine,PC,Al. May-10 to Oct-10

Billing Rep, posted all charges and payments /set up payment arrangement/insurance verification/filing claims/insurance follow up/worked denials and EOB's, I also assisted with back office duties including patients hpi/vitals and labs as needed.

Matria Healthcare, Marietta,Ga. Dec.-02-July-09:Care Coordinator/Referral Coordinator:In a call center environment, performed patient education on disease mgt,encouraged program retention.I defined and determined realistic goals with participants,identified and coordinated resources based upon their specific condition and contractual agreement,using current recommendations and guidelines encouraging them to take a more active role in his or her health care.. Referral Coordinator for special projects, responsible for accounts,followed up on each account until resolved,produced excel reports,tracked data for monthly stats for management. Preceptor/Trainer conducted training for new hires,demonstrating proper usage and basic knowledge of the work flow,monitored and evaluated calls of new employees interactions with participants for quality assurance.

GASTON LOUGHLIN, INC. , ATLANTA, GA AUG-01 to Dec.-02 Triage Coordinator: Triage first injury calls from employees,accessing injuries and routing them to contracted care provider. Team Leader/Supervisor : Responsible for the training of new employees,scheduling and department coverage. Performed weekly and monthly stats as well as follow ups re workman compensation issues.

Training/Marketing Rep:Represented this facility along with Risk management Conducting training sessions with Dekalb Co.Gov.Marta,State Of Ga.implementing new updates,policies and procedures,conducted in services for Supervisors and Administrative staff as it related to Occ.Med and work related injuries.

Dr.DOUGLAS SATCHER, RIVERDALE, GA AUG 2000 to August 2001 Billing Coordinator- financial counseling for patients in collections, monitored co-pays,posted all payments,billed insurance for payments, Insurance follow up/denials. Referral Coordinator: located providers for patients,obtained authorization and scheduled appointments.Credentialing:Updated and verified physician licenses and insurance data,communicated with hospital staff to assure physician chart documentation was current,help to prepare for various evaluation,etc..

GEORGIA UROLOGY, RIVERDALE, GA July 1999 to August 2000 Physician Credentialing:Tracking and updating physician information,licenses,insurance,applications and fees.Account Representative: Insurance follow up various ins including HMO,PPO,identified discrepancies in billing,coding and third party payers Referral Coordinator: obtained prior authorizations from insurance companies for surgery patients.

Education:

Dekalb College

Georgia Medical Institute

Computer Skills

Windows

Microsoft Office/Word

Medisoft

Medical Manager

Reference Available Upon Request

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