Danielle Gullette
Oakland
Summary
Results-driven professional with extensive experience at One Medical, adept at resolving complex issues and ensuring compliance while delivering exceptional service. Skilled in collaborating with teams to achieve goals and adapt to changing requirements. Dependable and resourceful with focus on effective communication and problem-solving.
Overview
9
9
years of professional experience
Work History
Payer Accounts Receivable
One Medical - Remote
11.2021 - Current
- Increased revenue by identifying and resolving billing errors on denied claims.
- Documented all activities related to unpaid claims and denied services to ensure accountability and streamline follow-up processes.
- Successfully navigated complex insurance claims by submitting well- documented appeals with all supporting medical records within timely filing which resulted in recovery of substantial amounts of previously denied payments.
- Collaborated with cross-functional teams to address and resolve billing issues, improving overall claims resolution efficiency.
- Fostered strong relationships with healthcare providers to ensure billing and coding accuracy.
- Communicated consistently with insurance companies to clarify billing issues and facilitate timely follow-up on appeals and disputes. with various insurance companies to follow-up on appeals, reprocessing disputes, missing payments and credentialing issues.
- Identified larger scale issues by recognizing patterns and trends relating to clearinghouse rejections, credentialing or systematic issues.
Administrative Assistant
One Medical
01.2018 - 11.2021
- Verified insurance coverage and benefits.
- Obtained prior authorizations for referrals related to scheduled procedures, diagnostic testing, pharmaceuticals, and DME to facilitate timely patient care.
- Followed up with insurance and notated patient accounts regarding authorization status.
- Appealed denied pre- authorizations for referrals, procedures and pharmaceuticals.
- Managed patient medical records, ensuring accurate submission of supporting documentation and coordinated with providers to secure additional information as needed.
- Answered multi-line phone system, routed calls, delivered messages to in office physicians.
- Coordinated patient scheduling, check-in, check-out and processed payments.
- Delivered excellent customer service through prompt responses to patient inquiries regarding various concerns such as billing, medication renewals, referrals, and scheduling.
- Managed the secure transfer of medical records between facilities, ensuring proper adherence to privacy regulations and patient confidentiality guidelines.
- Assisted billing department with insurance denials and appeals for in- house claims.
- Trained new administrative staff, sharing expertise and best practices to enhance team competency and support smooth onboarding.
- Assisted the recruiting team by conducting video interviews to review and evaluate individual candidates. Collaborated with managers for post interview debriefs.
Education
High School - Diploma
Skills
- HIPAA compliance
- Medical terminology and ICD-10 coding familiarity
- Electronic Health Record proficient
- Microsoft Office
- Time management
- Organized
- Collaborative
- Excellent interpersonal skills
- Independently motivated
Timeline
Payer Accounts Receivable
One Medical - Remote
11.2021 - Current
Administrative Assistant
One Medical
01.2018 - 11.2021
High School - Diploma