| Candidate Information | | Title | 3Rd Shift Customer Service | | Target Location | US-IN-Indianapolis | | Phone | Available with paid plan |
| | 20,000+ Fresh Resumes Monthly | |
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Click here or scroll down to respond to this candidateDEBORAH D. ROBINSON /PHONE NUMBER AVAILABLEStreet Address /deboragh51@gmail.comOPERATIONS MANAGEMENT / OFFICE BILLING & MEDICAL COLLECTION OPERATIONS EXECUTIVE SUMMARY:Strong leadership, analytical, communication, negotiation and interpersonal skills: Current debt Obtaining detailed financial statements from consumers to determine capacity to pay Utilizing research software to verify assets and demographic information Recommending defined legal efforts based upon the clients account circumstances Maintaining the high standards of professionalism and customer service expected by our clients Medical background contain of lot of claims processing, coding claim check, C3 (clear claim connection), writing - an argument the main ideal or the claim to process or it denial of the claim providing supporting documentation the claim to pass if it didn't go on First Pass, work with McKesson software working 835 audit report to ensure that the charge was paid out correctly on any takes back or recoupment. I have used my coding, auditing, in the following jobs IU Billing, DXC, Anthem,EDUCATION:MBA -Business Administration Indiana Tech University- 2016 Concentration Marketing Management ConcentrationBusiness Management Bachelor ScienceBS-Business Administration Concentration Accounting Associate Science 2009 Accounting Indiana Tech University-AS- Electronic Technology IT ITT Technical Institute- 1997 AS-Business Administration Concentration Computer Programmer/ INFORMATION SYSTEMPROFESSIONAL EXPERIENCE:11/27/22 -Current @ HEARTLAND FOOD PRODUCTS - Machine Operator Jar Sleeves running the Sleeve to make sure the correction labeling is on the correct products, paperwork checking every hour. Palletizing, running labels, wrapping the products, moving to the warehouse, communicating with the forklift drivers, ordering Raw materials for the jobs. Other machines when short staff.MS-IL STAFFING AGENCY: VARIOUS ASSIGNMENTS8/6/22 -11/25/2022 3RD SHIFT @ HEARTLAND FOOD PRODUCTS MANUFACTURING Machine Operator Jar Sleeves running the Sleeve to make sure the correction labeling is on the correct products, paperwork checking every hour. Palletizing, running labels, wrapping the products, moving to the warehouse, communicating with the forklift drivers, ordering Raw materials for the jobs. Other machines when short staff.10/15/21 - 03/20/21 3RD SHIFT @ GLOBAL PLASTIC MANUFACTURING Press Operator, Training of new worker, helping with production paperwork, running press machine on different parts, for Auto, Food, working on Mode Injection press, making a variety of products.MS-IL SATTING AGENCY: 03/30/22 - 11/20/22 3rd SHIFT @ IFCO Sorting and Auto washing of food crates that hold products product.MS-IL - 10/15/21 - 03/20/21 3RD SHIFT @ GLOBAL PLASTIC MANUFACTURING Press Operator, Training of new worker, helping with production paperwork, running press machine on different parts, for Auto, Food, working on Mode Injection press, making a variety of products.BCForward Staffing Agency - 11/2018 -5/3/2019 Licensing and Credential Financial department @ Anthem Working with get credential Documentation is from the brokers which will allow them to get set up to start selling Anthem products. Also working the hotline receiving calls from Brokers, FMO's, GMA, and with Anthem Internal agents for setting up New Agent set up Exiting Brokers for selling Anthem products. Duties also included hotline phone calls inquiry to the Broker email box, answering letters emails using variety of systems SFDC-Sale Force.com, Outlook, Skype the Broker portal, NIPR, NMF-No More Forms site BPM site, Running background checks, DOI, on potential new agent and much more.BCForward Agency- Contract - Anthem 7/16/18 - 9/11/18 MMS I (Medical Management Specialist) Working in a workflow queue to move medical documents. From one system into another, so that the clinical documentation can then be review by the Medical Director to approval or denial. Working in a workflow queue to assure all daily intake of work is complete in a timely fashion, assistance the team with MDR Medical Doctor Reviews, Clearing out the OB-Delivery stay of the queue for proper billing purposes, working DC Discharge notice and inputting New Admission on Long Term Acute Care (LTAC), Skilled Nursing Facility (SNF), Acute Inpatient Rehab (AIR), making sure they are code and entered into the Intake queue so the Clinical can be review by a Nursing. System use were Outlook for meeting and Schedule of daily work task, Skype for virtue meeting for remote staffs and management, Pluses which is Anthem Home screen to located work application, IT functions, Training folders, and many other documents, also Excel for daily Tally working tracking system, Pluto, Atlas, Masses, Facets, Dot Tool Electronic Clinical note taker, and more system for daily operation to complete your work tasks.Smart IT/One Bridge Agency-Contact: - DXC Technology. 8/20/2017- 7/06/18 Written Correspondence Analyst Address the Provider (Medical, Transportation, Hospital, DME supplier) in writtencorrespondence to their questions, problems, concerning on to their claims, directing them through the Indiana Healthcare Portal (IHCP) and the Indiana Medicaid Portal for answer to their billing needs, reimbursement, rate and what will help them to get there claims processing and paid timely and referring them to the Bulletins (BT) and Banners (BR) that are available to the provider. Making sure all the correspondence whether it by secure mail, correspondence mailed batches, all within the State of Indiana guidelines of 4 business days. Help with the support of IHCP Provider Annual Workshop. Monthly meeting with the Field Reps In-house Reps and Written Correspond DXC team to talk about changes, problems, any changes that the State has made for procedure, rules, and guidelines. System : OnDemand, Government site( Indiana Medicaid, PRDDOC, CoreMMIS, SharePoint, Outlook, Skype (messaging), OneNote, Excel, Snipping Tool, Adobe Reader, Adobe Write, Google Chrome, Sickly Notes, Notepad (logging),Service Master(logging tickets) NCCI, Data motion Secure Mail Inbox, CAT- (recorder).Payroll System (time tracker), Indiana Title XIX-Home, Secure Mail Portal (internal), Microsoft Office,Word, Power Point, Pulse Secure Connection (HPE), HPE Digital Badge Cisco System VPN Client (WAH), Using Claim Check -for coding auditing software used for the claim processing and automated claim reviews, reading the 835 audit report on any claim that were kicked out and didn't make it through First Pass ensuring that the code was the right one for the procedure. Using the McKesson edits system to resent the codes back thought for processing to ensure that it is timely filing.Ascension Health - St. Vincent - Heart Center: 4/3/2017- 7/21/2017 Surgery Specialist Billing - Cardiovascular Surgery -OR Dept. Billing Charges -Posting and Audits for OR department, Case Log andStatus Record keeping and documents, FCOTS - First Cut on Time Start procedure logging and data entry, Implants log and status documents, SSU (Short Stay Unit) Data and Charges entry, Productivity Report daily, CDM (Charge Data Master) requests and Item added on Maintenance, Paperwork - making sure that the OR documents are keep up and printed out for the staff, keep the form up to date and supply in the OR form cabinet. Call Schedule Log- each Monday making sure the Call Schedule log is disturbed to Team member and leads and updating the log each week, Community Benefit board - keeping update Events on the board, Meeting - taking note for the weekly meeting, Preferences Card - keep the Doctor Preference sheet for his procedure up to date and other duties.Thats Good HR Agency- Contact - ST. VINCENT HEALTH: - COLLECTION/CREDIT 3/6/17-3/31/2017Follow Up Rep. -Credit Collection - Facility billing posting payment for Medicare, follow-up on whyclaims were not billed out or why payments received. Rebilling to the carrier also contacting the Insurance carrier for follow-up work to get the claim paid. Work about 13 Facilities. Daily reports reconciling payment for each Facility, any other special project needed.K. Forces-Contract: 6/6/16- 1/20/2017 IU HEALTH RETAIL PHARMACY BILLING, INDIANAPOLIS, IN (GATEWAY) Billing Specialist AnalystResponsible for Deposit (rotation) Pulling PNC information, Putting information onto work folder for each store, Posting patient internal payments for your assigned stores, Reclassing payment in Category 1, Checking for Assigned stores, Locbox for Assigned stores, Unapplied
All other Categories for Assigned stores, Mail, Credit Card reconciliation, Phones, Manual deposit in theInmar System, Reconciling in QS/1 system, Claim Check report, Running 835 Applied Reports on your Assigned stores, McKesson edits to ensure that the claims goes through on First Past. Database system to do Emdeon Release on your assigned date, working Audits Daily on your Assigned stores, billing the Primary and Secondary Paper Claim from the Database and QS/1 each week, Running Unapplied Report on your Assigned week of Deposit, and work your Assigned Stores, Posting in QS/1 all Primary and Secondary payment received from the Locbox and Checking, working any Denials, Corresponded received through the mail, Locbox, Run Central Pay Report and do the CSV file for uploading to Inmar daily for your Assigned store. Working Credit Card payment from the Corresponded and recon them in QS/1 on your Assigned week, working daily on the 835 Reconciliation files for your Assigned stores, posting any Variances from the report in the QS/1 system, Working in Remote Tracker for RX subscription documentation, UPS Tracking System on patient delivery shipped. Using Outlook email for communication to other department and sending reports and follow-up tracking system. Using WinSCP system for electronic transfer of files and report. Working in Adobe Acrobat XI Pro for many functions like creating files and scanning any documentations for future follow-up, Combine report into one single pdf file. Printing of HCFA form on paper claim if they do not go electronically.Kelly Services Contract: - KBA-Key Benefit Administration of Companies. 8/2015-2/16/16 OperationalAccounting Key Account Analyst- Premium Lapse Collection Analyst Data Reports Daily, Auditing Accounts Balancing Reports, Outlook Email reply daily, follow ups Calls to Clients on Outstanding balance, working on Stop Loss reports, Term Report, Lapse Report, Reconciliation of policy with the Companies/ Employers.Kelly Service- Contract - JARDEN HOME BRAND: FISHERS, IN 2/16/16/- 4/1/16 Collection Credit Analyst Specialist Responsible for the process and control of customer invoices, sales order using effective communication with operations and detailed verification of invoicing to the customers. Follow-up on customer Aging report weekly. Receive and respond to inquiries from customers, sale staff, internal departments, and vendors. Use professionalism and diplomacy to handle complaints, answer or initiate correspondence and make every effort to satisfy the customer. Using Excel spreadsheet, Data Report, Outlook, Email Tracking, SAP. Run and analyze daily reports in SAP. Complete daily performance metrics and contribute to meeting customer's expectations. Run and analyze aging over 90 days, 60-90 days, 31- 60 days, 120- days report each week. Maintain an Incoming Collection email box on client A-Z sort, Jarden Home Brand, Lifoam, United States Playing Card, Firelog. Maintain processes and documentation, including releasing of sales orders, creating delivery documents within allotted time, updated and customer credit status. Develop and maintain effective working relationships with customer/ making sure customer has everything they need to get their inventory paid. Working with and maintain effective relationships with transportation personnel to assure proper shipping rates, routing, traces, and proofs of delivery. Develop and maintain effective relationships with Regional Sales Managers in designated regions with the other Customer Service Coordinator where regions, inventory, or customers overlap.Maintain communication with the customer through phone calls, email, follow-up Credit Hold Accounts.Balance Report Daily, Excel, V-Lookup, Pivot Tables, Graphs and Charts, Reports and. Spreadsheets. Analyst carrier report daily. Contacting Clients daily concerning their accounts.Kelly Service Contract: NGS- National Government Services- 10/2014- 6/2015 PE-Provider Enrollment/Indexer Part B /J6 Providing services from PE- (Provider Enrollment) of services and updates or change within the contract. Receiving Provider Applications for entry and maintaining of information for processing daily. Working within Case 360 Release notes system - which receives and tracks the application case information work loaded. PECO, PE Revalidation, PE search Queries, File Cabinet Retrieval of application cases history, Mail Clerk Queue, - daily work Queue. Indexing the information into these systems for complete processing of documents.K Force-Contract - IU-Health Care: Revenue Center 08/2014- 10/2014 Customer Care Specialist Provided services to family, patients, updates, changes, billing information correction, policy information changes, HIPPA regulation, System updated and changes patient charting, system IDX Polic system Hospital, Clinic, SMS-Physician billing information, Cerner- Registration interfacing for the Hospital and surrounding clinics, Doctors offices. Maintaining and patients account. Incoming and Outgoing call ques. Follow up with family members, patients, other supporting office on information, rebilling of charges, Medicare and Medicare Mainframe system for updates and changes, Commercial Insurance billing and much more.Frontier Telecommunication (Verizon Communication): 11/2005 - 11/2013 Consumer Credit/Collection Specialist Provided services associated with internal and external customer billing and payment processing operations. Resolved account problems and issues with excellent customer service. Setting up payment arrangements to help meet the business model guideline of assisting the customer. New service, offering service and products, training and update on new system and technique on Customer Retention.IMC Credit Collection 08/2003: - 11/2005 Collection Specialist Administer and enforce credit and collections policies and procedures Develop strategies, and goals to reduce exposure to write-offs. Reviewed accounts receivable aging reports while providing direction for collection activities and identifying collection difficulties. Evaluate credit risk. Understand credit and collection processes, training staff, provide support, and foster improvements and efficiencies.Irvington Radiology- Billing: (Commercial, Medicare, Medicaid, INS 07/2000 - 08/2003 Communicate with customers, competitors, suppliers, professional organizations, or others to stay abreast of industry or business trends. Identify or monitor current and potential customers, using business intelligence tools. Billing of all parties of Insurance Carrier Medicare, Medicaid, All Commercial) collecting and setting up payment arrangement after the Insurance, Analysis EOB for all payment, denial codes, filing claims. Sending out letters to patients, Insurance Carrier, Skip tracing, setting up payment arrangementsN.W.R. Northwest Radiology: 06/1995 - 07/2000 Business office A/R department Collection followup A/R-Department understanding of all procedures and posting of account receivables Collection on patient account balances after insurance, or self-paid account, working out Payment plan, charity guild lines, hardship cases, interacting with our collection agency on Accounts matters. Assisted patients with their billing and worked out a plan that fit their needs. Collection of money and setting payment arrangements. Working with a skip tracing program to locate the debtor on the account balances.REFERENCE UPON REQUEST |
