Darlena Hale
Portland,OR
Summary
To obtain a long-term career opportunity, utilizing my accounting, medical billing and office skills, with the opportunity for personal, career growth and advancement.
Overview
17
17
years of professional experience
Work History
Finance Specialist II
Multnomah County
Portland
02.2018 - 10.2023
- Lead technical authority for multiple units, under the Financial and Business Management Division
- Conduct professional accounting, budgeting, auditing and financial planning projects in order to maximize organizational revenue
- Prepare extensive reports, tracking tools, and other supporting documents that maximize revenue and accurately reflect the financial position of specific programs
- Developing systems, test assumptions, uncover discrepancies, create and optimize technical methodologies, and provide training to other staff members in procedures to ensure accuracy of reporting
- Independently prepare, monitor and audit internal controls for assigned programs and make recommendations to senior managers
- Developing and using trend analysis to project future revenues and expenses
- Drafting policies.
Claim Accounting Specialist
Performance Health Technology
Portland, OR
12.2012 - 01.2018
- Improved financial accuracy by performing detailed account reconciliations and resolving discrepancies.
- Reconcile revenue and expense transactions.
- Data entry of expenditures for tracking and reconciliation purposes.
- Documents specific claims by completing and recording forms, reports, logs, and records.
- Analyzes insurance claims to prevent fraud.
- Establishes proof of loss by studying documentation/assembling additional information from outside sources.
- Resolves claims by approving or denying documentation, calculating benefits due, and determining compensation settlement.
- Support contracting processes and provides legal support by assembling documentation for settlement action as needed.
Claims Analyst
FamilyCare Health Plans
Portland
06.2010 - 12.2012
- Reduced claims processing time by implementing efficient analytical techniques and strategies.
- Enhanced customer satisfaction by resolving complex claims issues in a timely manner.
- Review prepared reports, tracking tools, and other supporting documents to identify account discrepancies.
- Investigate and finalize incoming claims timely, with precise accuracy and in accordance with all applicable policies and guidelines.
- Analyzed claim data to identify trends and recommend process improvements.
Follow-up Specialist
Legacy Health Systems
Portland
06.2006 - 05.2010
- Resolves delinquent payment issues of complex accounts requiring advanced knowledge of multi-payer systems
- Investigate and evaluate patient account information, medical records, billing and reimbursement regulations
- Analyzes each account, using independent judgment decides how to best proceed with follow-up to optimize reimbursement
- Remove barriers to complete claims processing
- Negotiates financial arrangements and individual contracts with third-party payers
- Rebills, payment transfers, refund requests and adjustments of misapplied payments.
Education
Concorde Career Institute
Portland, ORPortland Community College
Portland, ORSkills
- Ten Key (by touch)
- Scheduling
- ICD-9/10
- HCPC codes
- Collections
- Medical Terminology
- A/R & A/P
- Strategic Planning
- Medical/Insurance Billing
- Financial Statements
- Audits
- Regulatory Compliance
- Financial Reporting
- Compliance Requirements
- Data Gathering
- Records Management
- Project Management
References
References furnished upon request.
Timeline
Finance Specialist II
Multnomah County
02.2018 - 10.2023
Claim Accounting Specialist
Performance Health Technology
12.2012 - 01.2018
Claims Analyst
FamilyCare Health Plans
06.2010 - 12.2012
Follow-up Specialist
Legacy Health Systems
06.2006 - 05.2010
Concorde Career Institute
Portland Community College