Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
21
21
years of professional experience
Work History
Account Receivables Specialist- Lead
Change Healthcare
Pittsburgh, PA
03.2017 - Current
Research and verify automated Work Queues in MDIV.
Responsible for ongoing projects and communicating results. Handles other special projects as requested.
Oversee daily department functions and processes are done timely and accurately.
Monitor team training and identify that members have required tools to perform job duties.
Mentor, motivate and coach team on daily basis.
Field any escalated calls, posting complaints or questions and insure timely resolutions.
Reconciled accounts, managed audits and updated financial records with remarkable accuracy.
Generated invoices upon receipt of billing information and tracked collection progress.
Responsible for handling Transplants, Cosmetics, International, Family Planning accounts.
Perform monthly quality audits.
Accounts Receivable Specialist
McKesson Change Healthcare
Pittsburgh, PA
04.2015 - 03.2017
Research and re-bill unpaid claims
Research and resolve accounts appearing on Follow-up Reports.
Make appropriate decisions and calls to carriers to maximize reimbursement on accounts to be worked.
Correct all errors on electronic error reports using all available information.
Meet current production, utilization, and quality standards.
Assists in identifying current and/or potential billing issues specific to outstanding receivable
May participate in trainings/meetings with Payers, internal departments, offshore partners, Client contact(s) and TES Management, etc. to address trends in denials or unprocessed claims
Presenting data to appropriate parties and partnering to develop resolutions
Participates in daily production assignments that will continue to develop understanding and knowledge of processing guidelines and expectations of respective client(s) payer mix
Ability to take patient phone calls and assist Customer Service when business needs arise
Assist in other duties as assigned
Supervisor/Customer Service Pharmacy
Highmark Blue Cross Blue Shield
Pittsburgh, PA
05.2005 - 03.2015
Monitored metrics and developed actionable insights to improve efficiency and performance.
Conducted training and mentored team members to promote productivity, accuracy and commitment to friendly service.
Coached employees through day-to-day work and complex problems.
Putting together daily performance reports for senior managers.
Maintained compliance with all regulatory entities (i.e., DOH, CMS, NCQA, etc.)
Provided leadership, management and guidance to all Call Center staff.
Lead/Customer Service Pharmacy
Highmark Blue Cross Blue Shield
Pittsburgh, PA
01.2005 - 05.2006
Develop, plan and implement process improvements resulting in quicker turnaround times and reduction in errors.
Implementing appropriate procedures for Pharmacy Care Management Reps.
In order to comply with corporate initiatives and regulatory requirements.
Act as liaison to Member Service, grievance departments and to Medco for issues related to operational aspects of our clinical management programs.
Pharmacy Care Management Representative
Highmark Blue Cross Blue Shield
Pittsburgh, PA
04.2002 - 01.2005
Resolved customer's inquiries and complaints via written, telephonic, or face-to-face communications in a timely and accurate manner.
Meets all production, quality, adherence standards.
Attends all required training classes.
Elevate issues to next level of supervision, as appropriate.
Developed and maintained courteous and effective working relationships
Education
High School Diploma -
Steubenville High School
Steubenville, OH
05.1989
68 Credit Hours of Business Adminstration
Central State University
Wilberforce, OH
Skills
Accounts receivables
Customer Relations
Team Collaboration
Customer Service
Problem Solving
Positive Attitude
Thrives under pressure
Valued Team player
Supervision and Training
Accomplishments
First Level Leadership Training Program
SOAR Recognition Award Rapid Improvement
Timeline
Account Receivables Specialist- Lead
Change Healthcare
03.2017 - Current
Accounts Receivable Specialist
McKesson Change Healthcare
04.2015 - 03.2017
Supervisor/Customer Service Pharmacy
Highmark Blue Cross Blue Shield
05.2005 - 03.2015
Lead/Customer Service Pharmacy
Highmark Blue Cross Blue Shield
01.2005 - 05.2006
Pharmacy Care Management Representative
Highmark Blue Cross Blue Shield
04.2002 - 01.2005
High School Diploma -
Steubenville High School
68 Credit Hours of Business Adminstration
Central State University
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