Donna L. W. |
Seeking employment with a reputable firm where my experience can be
utilized for the benefit of the firm and for my own financial security.
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
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
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
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.
daily payments, and verified insurance eligibility.
SOUTHEAST COLLEGE OF TECHNOLOGY
A.S. Computer Programming