Audrey Moore
Charlotte,NC
Summary
With extensive experience in providing exceptional benefit support, I am a collaborative and results-driven professional who excels at delivering exemplary service. I possess a strong understanding of federal, city, and state insurance regulations, ensuring compliance while maintaining strict patient and employee confidentiality. As a precise Accounts Receivable Manager, I specialize in account reconciliation and invoice collections, consistently achieving outstanding results. My superb communication skills enable me to tactfully address delinquent payments and resolve issues with diplomacy. Furthermore, I have a proven track record of successfully managing teams of employees.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Tricare Certified Health Benefit Consultant/Referrals/ Claims /Authorization Specialist
Summit/Village/City MD Medical Group
01.2023 - 07.2024
- Obtained authorizations/Referrals for all imaging studies
- Worked in conjunction with servicing providers, office staff to ensure the authorization status of requested image study is relayed in a timely manner
- Formulated clinical appeal letters to insurers
- Heavy communication with Utilization Review and Physician Support services
- High call volume
- Heavy numeric caseloads
- Reviewed claim balances and payment methodology for HMO, PPO, Medicare, Medicaid and all Commercial carriers
- Verified benefits via all assigned portals
- Reported claim discrepancies and identified claim issues.
Licensed Insurance Agent
TZ Insurance Solutions
11.2021 - 12.2022
- Educating Medicare eligible population on Medicare advantage carriers
- Responsible for sales of Medicare Advantage in contact center like environment
- Identify eligible prospects via phone
- Heavy call volume
- Adhere to required conversion rates.
Health Benefit Consultant
US Family Health Plan
01.2014 - 09.2021
- Responsible for sales/enrollment management
- Provided education to eligible Tricare beneficiaries on US Family Health Plan and other Tricare eligibility
- Applied prospecting marketing techniques to develop briefing sites, event sites
- Established core relationships with military command units
- Participated in all Pre and Post deploy functions
- Created sponsorship agreements in all military bases in NYC region to educate, brief and assist Tricare eligible on enrollment processes
- Established retention guidelines
- Trained all incoming Health Benefit Consultants on front end in office and field operations.
Accounts Receivable Supervisor
Montefiore Medical Center Moses Division
04.2010 - 09.2013
- Enhanced team productivity by providing regular training on accounting software and tools.
- Conducted census, financial, and insurance reports of payors to determine necessary actions for overdue or credited accounts.
- Resolved complaints from clients and customers and fielded overall company reviews.
Education
Business Administration/Marketing - Business/Marketing
College of Westchester
White Plains, NY06.2013
Associate Applied Science -Marketing and Business Management - Business/Marketing
College of Westchester
White Plains, NY06.2013
Skills
- Accounts receivable reconciliation
- Benefits Administration
- Authorization for imaging,acute care,ambulatory service,DME
- EMR
Certification
- Tricare Certified
- HIPPA Certified
- COVID Tracer Certified
- Licensed Insurance agent- Life and Health
Accomplishments
- 40% enrollment increase in all assigned territories.
- Created "Triage Process" for all eligible, decreasing disenrollment by 20%
- Increased provider network in territory by 10%.
Affiliations
- 999 High Street Tenants Association, President Red Cross
- Don Bosco homeless shelter
- Bethel Baptist Church youth leader
Additional Information
Punctual , responsible able to execute directives. Enjoys multi tasking. Easy to adapt to new encironments. Efficient in insurance portals, EMR navigation.
Timeline
Tricare Certified Health Benefit Consultant/Referrals/ Claims /Authorization Specialist
Summit/Village/City MD Medical Group
01.2023 - 07.2024
Licensed Insurance Agent
TZ Insurance Solutions
11.2021 - 12.2022
Health Benefit Consultant
US Family Health Plan
01.2014 - 09.2021
Accounts Receivable Supervisor
Montefiore Medical Center Moses Division
04.2010 - 09.2013
Business Administration/Marketing - Business/Marketing
College of Westchester
Associate Applied Science -Marketing and Business Management - Business/Marketing
College of Westchester
- Tricare Certified
- HIPPA Certified
- COVID Tracer Certified
- Licensed Insurance agent- Life and Health
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