Customer Service Insurance
Resume:
GLORETHA RHACHELLE WALLACE
**********@*****.***
PROFESSIONAL SKILLS
Excellent Organizational Skills
Strong Customer Relations
Computer Proficiency
Word Processing & Typing
Data Entry
Filing
PROFESSIONAL EXPERIENCE
Kindred Hospital Dallas Aug 2010 – Current
Biller/Collector
• File claims for both commercial, Medicare and Medicaid Insurance.
• Bill both inpatient and outpatient stays.
• Follow claims throughout process until paid correctly.
• Determine DRG rate and Per Diem claims.
• Verify benefits and coverage.
• Obtain authorization for hospital stay.
• Collections.
• Calculations of Medicare days used and not used in order to load into Meditech.
Diversified Billing Feb 2009 – Aug 2010
Biller/Collector
• Filed claims to insurance - both government and commercial.
• Identified co-insurance and deductibles.
• Submitted billing to patients.
• Read and explained EOB’s to patients.
• Filed appeals as needed and performed follow up.
• Set payment plans and performed collections.
• Customer service.
Presbyterian Hospital of Dallas 2000 – 2008
Patient Access Specialist
• Performed preadmissions.
• Verified insurance coverage.
• Estimated payments.
• Patient registration and escorts.
• Read and explained ABN.
• Performed upfront collections.
• Knowledge of coinsurance and deductibles.
Rehab Works 1995 - 2000
Billing Specialist – Northwest Region
• Performed billing for 18 rehabilitation facilities.
• Verified payments were correct by matching with therapists’ record of treatment.
• Billed Medicare once bill was clean.
• Filed fraudulent claims when needed.
COMPUTER SKILLS
WordPerfect 5.1, Microsoft Word, 10-key, Data processing, Meditech, SSI, PcP, PPS calculator & FSS(Medicare system)
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