Allison Glass
Dallas,TX
Summary
Dallas, TX Support and train patient access representatives prebilling and post billing rejections. Training employees. Help manager with excel reports Encouraging manager and analytical problem-solver with talents for team building, leading and motivating, as well as excellent customer relations aptitude and relationship-building skills. Proficient in using independent decision-making skills and sound judgment to positively impact company success. Dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance. Insightful Manager with experience directing and improving operations through effective employee motivational strategies and strong policy enforcement. Proficient in best practices, market trends and regulatory requirements of industry operations. Talented leader with analytical approach to business planning and day-to-day problem-solving.
Overview
26
26
years of professional experience
Work History
Edi Billing
Edi Rejections, Parallon
Dallas, TX
02.2020 - Current
- Rejections,auditing, training, prebilling and post billing
- Help with reports for manager
- Executed billing tasks and recorded information in company databases.
- Checked insurance eligibility by making appropriate phone calls and conducting research on services rendered.
- Collected data to complete detailed financial reports for stakeholders and management.
Patient Access Representative
OPTUM CARE MEDICAL GROUP
Addison, TX
10.2017 - Current
- Help co-workers with questions and escalated calls
- Coaching and supporting coworkers
- Training new employees
- Using CMA 1500 and UB billing insurance
- Follow up insurance denials
- Appealing denials
- Interacting with doctors office for coding
- Contacting patients for correct insurance,balances,explaining
- EOBS
- Corresponds with email to patients and doctors office in a timely manner
- United healthcare
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
Claims adjuster
Blue Cross Blue Shield Of Texas
Richardson, TX
06.2017 - 10.2017
- Adjust claims
- Work in production and quality
- Worked with hipaa guidelines
- Manages numerous programs.
- Examined claims forms and other records to determine insurance coverage.
- Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.
- Maintained suspicious claims database and prepared reports for supervisors.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
- Answered questions posed by insured and attorneys.
- Compared data from surveillance footage to data on medical reports.
- Investigated claims involving potential and suspected fraudulent activities.
Patient Service Representative
Conifier health solutions
Frisco, TX
07.2016 - 03.2017
- Assist patients in registering for tests and surgery
- Coded in the computer for codes for types of registration
- Collected payments explained benefits
- Added new insurance, updated information
- Made outbound and answered inbound calls
Claims Examiner
Health Care Service Corporation
08.2010 - 10.2015
- Research claims on the Blue Chip Blue Card Rap FSS Premier
- Analyze claims on a daily basis for accuracy
- Possess the skills and knowledge to adjust a claim if claim it is not accurate
- Sent out medical request to providers answer GENINQS to the home plan
- Attach medical records for open prx
- Assisted department with training of new employees on an as needed basis
- Billing out hospital and professional claims
- Life Claim Customer Service
Dearborn National
11.2009 - 08.2010
- Handled incoming inquiries regarding life and disability benefits
- Inquiries consisted of: Groups calling in to report a claim or request status of a claim of one of their members
- Disability claimants requesting status of their benefits
- Family, Beneficiaries, or Funeral Homes calling in to report a death or to obtain status of a life claim
- Communicated to claim analysts via Seibel if further follow up to a caller's concern was required
- Utilized Docsql to answer most of the callers' questions regarding status of claims
- Assisted team on any additional project as needed.
Bookkeeper/Customer Service
Chiropractor, Dr. Gregory Shy
03.2009 - 07.2009
- Handled incoming inquiries regarding benefits, billing, and payments
- Made outgoing calls to obtain benefit information from insurance companies and to customers regarding collections
- Oversee office duties such as backup to receptionist for scheduling appointments and any other task at hand
- Responsible for confidentiality of records
- Developed strong relationships with customers, office staff, and doctors
- Supports daily operations in the doctor's absence.
Bookkeeper/Customer Service
Chiropractor, Dr. Gary Martin
06.2006 - 03.2009
- Handled incoming inquiries regarding benefits, billing, and payments
- Made outgoing calls to obtain benefit information from insurance companies and to customers regarding collections
- Responsible for auditing and maintenance of accurate accounting records
- Oversee office duties such as backup to receptionist for scheduling appointments and any other task at hand
- Responsible for bringing in well over $78,000 in unpaid and past due accounts
- Responsible for confidentiality of records
- Developed strong relationships with customers, office staff, and doctors
- Supports daily operations in the doctor's absence.
Staffing Manager
American Legion Post
02.1998 - 06.2006
- Supervised staff activities to ensure correct and efficient workflow
- Handles complaints and irate customers
- Frontline customer service, providing excellent service to patrons
- Scheduling and overseeing special projects and occasions to assure satisfaction of customers
- Handled stock in order to meet customer demand
- Responsible for payroll and taxes including tax preparation
- Reviewed applications and resumes to support hiring activities.
- Performed sourcing, interviewing, negotiations and hiring.
- Collaborated with legal and compliance teams to review paperwork, obtain feedback and procure available information for new training processes.
- Reduced process gaps while supervising employees to achieve optimal productivity.
- Provided resolution to complex and confidential issues.
Education
Bachelor of Arts - Healthcare Administration
University of Arizona Global Campus
Tucson, AZ03.2023
Skills
- EMR
- Billing
- Medical Records
- Scheduling
- Microsoft Excel
- Word
- Epic
- Clerical
- Outlook
- Medical Billing
- Medical Office Experience
- Hospital Experience
- Insurance Verification
- HIPAA
- Going to ashford university for my BA in Healthcare administration (3 years)
- Medical terminology
- Computer skills
- Microsoft Office
- Accounts receivable
- QuickBooks
- Leadership
- Accounting
- Bookkeeping
- ICD-10
- Certifications and Licenses
- Caring and Empathetic
- Insurance Information Collection
- Building Rapport and Credibility
- Knowledge of Community Services and Programs
- Explaining Policy and Procedures
- Multitasking and Organization
- Scheduling Diagnostic Procedures
- Gathering Information From Patients
- Database Search and Data Entry Skills
- Verifying Eligibility
- Demographics Information
- Team Leadership
- Resolving Problems
- Providing Information and Resources
- Patient Identification
- Administrative and Office Support
- Insurance Company Knowledge
- Patient Confidentiality and Data Security
- Quality Assurance
- Encryption Software
- Team Collaboration
- Patient Health Information Access
- Medical Services Administration
- Insurance Form Processing
- Accounts Payable and Accounts Receivable
- Benefits Explanations
- Clerical and Filing Support
- Program Eligibility
- Financial Assistance Plans
- Medical History Documentation
- Insurance Coordination
- Insurance Authorizations
- Word Processing
- Claims Handling and Coverage Verification
- Delinquent Accounts Monitoring
- Patient Data Management Systems
- Billing Issue Resolution and Support
- Explaining Instructions
- Training Coordination
- Financial Procedures Adherence
- Calm and Effective Under Pressure
Additional Information
- Willing to relocate: Anywhere, Authorized to work in the US for any employer
Timeline
Edi Billing
Edi Rejections, Parallon
02.2020 - Current
Patient Access Representative
OPTUM CARE MEDICAL GROUP
10.2017 - Current
Claims adjuster
Blue Cross Blue Shield Of Texas
06.2017 - 10.2017
Patient Service Representative
Conifier health solutions
07.2016 - 03.2017
Claims Examiner
Health Care Service Corporation
08.2010 - 10.2015
Dearborn National
11.2009 - 08.2010
Bookkeeper/Customer Service
Chiropractor, Dr. Gregory Shy
03.2009 - 07.2009
Bookkeeper/Customer Service
Chiropractor, Dr. Gary Martin
06.2006 - 03.2009
Staffing Manager
American Legion Post
02.1998 - 06.2006
Bachelor of Arts - Healthcare Administration
University of Arizona Global Campus
Similar Profiles
Enzo IameleEnzo Iamele
Self Owned Buisness at EDI Trash CansSelf Owned Buisness at EDI Trash Cans
Callum InsleyCallum Insley
Engineering intern at EDI Conveyors LtdEngineering intern at EDI Conveyors Ltd
DEGNAN AUDREY TERENCE LAYKAMOINDEGNAN AUDREY TERENCE LAYKAMOIN
JURISTE COLLABORATEUR at CABINET D'AVOCAT MAÎTRE EDI SEKAJURISTE COLLABORATEUR at CABINET D'AVOCAT MAÎTRE EDI SEKA
Toni YoungbloodToni Youngblood
Licensed Realtor at DFW Britestar Realty PLLCLicensed Realtor at DFW Britestar Realty PLLC
Charmagne N. GelseyCharmagne N. Gelsey
Payroll Conversion Consultant at EmpowerPayroll Conversion Consultant at Empower