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<pre>Array ( [var] => cut_url ) </pre> Resume for Donna W. for Administrative / Clerical / Support / Healthcare & Social Assistance in Memphis, Tennessee. Search More Resumes for Administrative / Clerical / Support on Resumark.com #KTQ1Y9JNT
 

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Resume for Donna W. for Administrative / Clerical / Support / Healthcare & Social Assistance in Memphis, Tennessee




Occupation: Administrative / Clerical / Support Industry: Healthcare & Social Assistance
Country: United States City: Memphis
State: Tennessee ZIP: 38127



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                Donna L. W.  
                Belover Drive  
                Memphis, TN  
               
                                   
                                            
 
 
              OBJECTIVE  
 
Seeking employment with a reputable firm where my experience can be  
utilized for the benefit of the firm and for my own financial security.  
 
WORK HISTORY  
 
 
UNITED AMERICAN HEALTH PLAN OMNI CARE Memphis, TN  
 
Provider Services Representative: Act as liaison between the company and Tenncare providers   Delivery of monthly eligibility listings as well as follow up on any provider issues, regarding billing or payments. Also responsible for Inservices, Site Reviews, and submitting provider claims for payment. Possess strong communication, customer service and organizational skills.  Launched new product line and increased sales on provider market. Completed assigned projects at % of target date. Responsible for claim resolution regarding any provider claims and reporting solution to the state for corrective action. Also responsible for researching and resolving contract issues as well as some contract negotiation. 
 
 
SEDGWICK CLAIMS MANAGEMENT, Memphis, TN  
 
 
Call Center Customer Service Representative: answer calls in a call center environment entering data for Workman Compensation, STD, FMLA Disability Claims, with accuracy.  Advanced customer service and motivational skills.  
 
 
ACCREDO HEALTH SYSTEMS NOVA FACTOR Memphis, TN  
 
Patient Representative: Responsible for complex reimbursement  
issues, as well as the billing of infusion therapy claims, adjustments and the reconciliation  
of patient accounts. Responsible for quarterly balancing of bad debt and reconciling debt. Responsible for screening patients to see if they meet Financial Guidelines for assistance with medication. 
 
SYNDICATED OFFICE SYSTEMS Memphis, TN  
 
Patient Financial Counselor/Medical Eligibility Program: Responsible for screening self pay patients on the hospital census, with obtaining Medicaid, Tenncare, Cobra and Social Security benefits. Worked closely with Tenncare MCO's and the Dept. Of Human Services on retro reviews and the appeal process. Researched and forwarded adjustment requests to the Business Office Manager for adjustments for under and overpayments. Delivered eligible patients to Department of Human and Social Security for assistance.

 
 
OAKVILLE HEALTHCARE CENTER Memphis, TN

 
Accounts Receivable Clerk: Calculated daily census totals for nursing home residents as well as account receivable functions, and adjustments to patient accounts. Also submitted Tenncare/Medicaid applications to the Department of Human Services, as well as bookkeeping and basic office duties.  
 
BAPTIST MEMORIAL HOSPITAL Memphis, TN  
 
Claims Processor: Responsible for the billing of Medicare and Medicaid secondary and other insurance. Collection of past due accounts and verifies patient eligibility, as well as answer inquiries on patient accounts.  
 
Secretary: Answered incoming phone lines, greeted guests and vendors. Entered work orders into the AS computer. Completed assigned secretarial duties, including memos, correspondence, faxes, reports, payroll and employee records in windows based software.  
 
BAPTIST MINOR MEDICAL CENTER, Memphis, TN  
Data Entry Clerk: Entered data from patients encounter form into  
computer. Posted payments, maintained files and entered insurance information. Balanced  
daily payments, and verified insurance eligibility.  
 
SOUTHEAST COLLEGE OF TECHNOLOGY  
A.S. Computer Programming


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