Armonda Woodson
Dallas,TX
Summary
Results-oriented Manager with diverse background in management and customer service. Dedicated to providing excellent customer service and making operational and procedural improvements. Dynamic administrative professional and leader with 15+ years of experience playing key role in attaining daily objectives and long-term goals across diverse office platforms. Excel in timely and accurate processing of accounts payable and receivable and applying advanced analytical acumen. Strongly committed to raising productivity and service quality via strategic planning and allocation of resources as well as implementation of process improvements. Skilled receptionist and liaison with superior communication, computer, support and organizational skills.
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-solving and maintaining regulatory compliance with reputation for reliability and professionalism.
Overview
24
24
years of professional experience
Work History
Medical Claims Resolution Specialist 2
MultiPlan
07.2023 - Current
- Provided exceptional customer service throughout the resolution process, fostering client trust and loyalty.
- Participated in quality assurance initiatives to continuously improve the effectiveness of the claims resolution process.
- Increased accuracy in claims assessment through meticulous record-keeping and organized documentation.
- Evaluated and settled complex insurance claims in strict timeframes.
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
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.
Provider Resolution Specialist
United Healthcare
09.2015 - 10.2018
- Assist providers with benefits and eligiblity 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-EOBs) 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) Complete the documentation necessary to track provider issues and support overall root cause trending by Platinum Service Managers Deliver all information and questions in a positive, conversational and compassionate manner to facilitate developing a relationship with the provider, while providing the best customer service experience possible Meet the performance goals established for the position in the areas of: quality and service expectations 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
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.
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
Business
University of Phoenix
Tempe, AZDiploma -
David W Carter High School
Dallas, Garland, TexasSkills
- 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
- Claims investigation
- Documentation skills
Personal Information
Title: Medical Patient Account Representative
Timeline
Medical Claims Resolution Specialist 2
MultiPlan
07.2023 - Current
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
Diploma -
David W Carter High School
Insurance Adjuster
Texas Adjuster Training
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