Armonda Woodson
Medical Patient Account Representative
Dallas,TX
Summary
Claims professional with keen eye for detail and commitment to excellence bringing valuable experience in claims resolution and dispute management. Known for collaborative teamwork and achieving results am dependable and adaptable to changing needs. Proficient in negotiation problem-solvingand maintaining regulatory compliance with reputation for reliability and professionalism.
Overview
25
25
years of professional experience
Work History
Claims Resolution Specialist 2
Claritev
Remote, Tx
07.2023 - Current
- Resolved complex claims disputes through thorough investigation and analysis of policy details.
- Collaborated with cross-functional teams to streamline claims processing procedures.
- Monitored industry trends and regulatory changes to ensure compliance in claims handling practices.
- Contact healthcare providers via telephone to discuss specific claim dollar amounts and propose discounts.
- Address counteroffers, overcome provider objections, and apply effective negotiation skills to reach an agreement.
- Research provider billing practices and use supportive data to advocate for maximum cost savings.
- Seek out opportunities to establish ongoing or global payment agreements with providers for future claims.
Office Manager
One Stop Tax Services Inc.
01.2020 - Current
- Oversaw appointment scheduling and itinerary coordination for both clients and personnel.
- Oversaw office inventory activities, including ordering and requisitions, stocking and shipment receiving.
- Conducted tax reviews and compilations to identify potential exposure areas and provided suggestions.
- Audited client financial records to determine tax liability.
- Performed analysis on inventory, accounts receivable and accounts payable balance sheet accounts.
- Represented clients before federal, state and local taxing authorities.
- Remained educated in all current tax laws for both US
- Prepared federal and state income tax returns for individuals, businesses, trusts, estates and non-profits.
- Trained new employees on accounting principles and company procedures.
Patient Scheduler
Aspen Dental
Phoenix, AZ
08.2022 - 07.2023
- Managed patient flow and triage calls to prioritize patient needs and put efficient use of clinic resources.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Followed up with patients to reschedule missed appointments.
- Explained procedures to patients to reduce anxieties and increase patient cooperation.
- Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment.
- Verified insurance coverage and eligibility for medical services prior to scheduling appointments to prevent billing issues.
Provider Resolution Specialist
United Healthcare
Richardson, TX
09.2015 - 10.2018
- Assist providers with benefits and eligibility of patients Assist providers with setting up authorizations and notifications to assure proper claim coverage.
- Resolve complicated claims issue and support to assist with timely payments Resolve issues without review or approval reducing time and improving the overall provider satisfaction Perform a variety of complex, simple and closed/denied adjustments Communicates directly with the provider to analyze and identify the providers service issue (i.e.
- benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits-EOB'S) Utilizes all tools, resources, and systems available to drive towards resolution Proactively Takes necessary steps to prevent further service issues of similar type Navigate through the appropriate computer system(s) to identify the current status of the issue and provide appropriate response to claim issue using all resources and escalation points available within the service model Focus on developing a strong relationship with the provider by providing contact information, dedicated facsimile number, follow-up work as needed and owning the resolution of the service issue Seek opportunities to reduce the administrative burden on the provider by advocating new tools or submission points such as Optum Cloud) Comply with all current policies, procedures and workflows Icd-9, Icd-10 codes medical terminology.
- Maintained 100% compliance with all hospital and government regulations.
- Typed medical orders for procedures and laboratory tests.
- Tracked and escalated compliance, care and quality issues.
- Acquired insurance authorizations for procedures and tests ordered by the attending physician.
Collections Manager
Silverleaf Resorts
05.2007 - 09.2015
- Assist representatives in solving difficult issues on collection of past due balanced on accounts.
- Make outbound calls to follow up on balance issues.
- Assist owners with signing new contracts Re-educate owners on products and services Locate and notify customers of delinquent accounts by mail, telephone, or personal visits to solicit payment.
- Confer with customers by telephone or in person to determine reasons for overdue payments and to review the terms of sales, service, or credit contracts.
- Locate and monitor overdue accounts, using computers and a variety of automated systems.
- Receive payments and post amounts paid to customer accounts.
- Negotiate credit extensions when necessary Advise customers of necessary actions and strategies for debt repayment.
Collections Associate
AT&T
Richardson
03.2004 - 05.2007
- In-depth knowledge of different collection methods and severance process A strong desire to continually elevate the performance of the business as a matter of satisfaction Knowledge of Fair Debt Collection Laws.
- Dedicated and meticulous: Able to exceed both external and internal customer expectations.
- Managed collections and resolved customer inquiries to ensure timely payments.
- Increased revenue recovery through diligent follow-up on past-due accounts and effective negotiation tactics.
- Provided exceptional customer service to both internal and external clients, upholding the company''s reputation for professionalism and integrity.
Pharmacy Clerk
Medco Health Solutions
01.2001 - 02.2004
- Check to ensure that appropriate changes were made to resolve customers' problems.
- Contact customers in order to respond to inquiries or to notify them of claim investigation results and any planned adjustments.
- Refer unresolved customer grievances to designated departments for further investigation.
- Keep records of customer interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken.
- Talk with customers by telephone or in person in order to provide information about products and services, to take orders or cancel accounts, or to obtain details of complaints.
- Assist customer with ordering and cancelling prescription orders.
- Counsel customer on product and inventory.
- Resolved third-party rejection claims.
- Filled and processed prescriptions to ensure prompt and efficient patient care.
- Managed medication stocks, including conducting counts, labeling products and maintaining controls.
- Processed prescription transfer requests from competitors.
- Prepared prescription transfer requests from competitor companies.
Education
Insurance Adjuster
Texas Adjuster Training
Dallas, TX08-2021
Business
University of Phoenix
Tempe, AZDiploma -
David W Carter High School
Dallas, TX1997
Skills
- Microsoft Office, (Word, Excel, PowerPoint, Access, and Outlook), Lotus 1-2-3
- Problem solving
- Verifying orders
- Time management
- Quality assurance and control
- Documentation and control
- Conflict resolution techniques
- Management of remote employees
- Account Management
- Deadline-oriented
- Policy and Procedure Modification
- Service coordination
- Insurance Knowledge
Timeline
Claims Resolution Specialist 2
Claritev
07.2023 - Current
Patient Scheduler
Aspen Dental
08.2022 - 07.2023
Office Manager
One Stop Tax Services Inc.
01.2020 - Current
Provider Resolution Specialist
United Healthcare
09.2015 - 10.2018
Collections Manager
Silverleaf Resorts
05.2007 - 09.2015
Collections Associate
AT&T
03.2004 - 05.2007
Pharmacy Clerk
Medco Health Solutions
01.2001 - 02.2004
Business
University of Phoenix
Insurance Adjuster
Texas Adjuster Training
Diploma -
David W Carter High School