DARLENE B. FEARS
Jacksonville,FL
Summary
Experienced Health Care Specialist with over 20 years' experience. Dedicated employee with a strong drive to serve my community and pursue the improvement of health services to aid in patient satisfaction and experience.
Pursuing full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise.
Overview
25
25
years of professional experience
Work History
Assistant Claims Processing
Ascension Medical Group
05.2024 - Current
- Contributed to a positive work environment with strong interpersonal skills and proactive teamwork attitude.
- Answered incoming phone calls to process requests, transfer calls, or relay messages to appropriate personnel.
- Worked closely with management to provide effective assistance for specific aspects of business operations.
- Improved claim processing efficiency by implementing streamlined procedures and workflow adjustments.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Maintained confidentiality of patient finances, records, and health statuses.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
Financial Counselor II
R1 RCM
01.2016 - 02.2024
- Assisted patients with disability applications and financial assistance applications, including initial form requirements and following through to completion and approval
- Assisted with day-to-day clinic responsibilities such as scheduling appointments, verifying insurance, and contacting various agencies to assist with patient outreach / benefits
- Cross Collaborating with internal Payer teams to assist with patient insurance verification & applying active insurance to impacted claims.
Disability Advocate
Accretive Health
01.2011 - 01.2016
- Assisted patients with submission of disability, Medicaid, & SSI applications
- Worked collaboratively with various clinical staff to ensure positive patient experience
Business Office Assistant
Palm Garden of Jacksonville
01.2009 - 01.2011
- Assumed day-to-day responsibilities, including but not limited to cash/charge posting, insurance verification, fund disbursement, Medicaid applications, and patient concerns
Accounts Receivable Representative
HCR Manor Care (Corporate)
01.2000 - 01.2008
- Worked closely with insurance companies to obtain reimbursement on claims - Maintained 97% success rate for overturning denials
- Spearheaded the development of training manuals for onboarding as it pertains to secondary and tertiary billing requirements
- Developed and maintained customer relationships for the facility, by addressing and resolving customer concerns, as well as working diligently to resolve any barriers that may arise for patient care and/or reimbursement
- Responsible for cataloguing new products to facility system
- Streamlined billing processes for improved efficiency and reduced errors.
Education
Dual Masters - Business Administration & Healthcare Management
University of Phoenix
Phoenix, AZ - Online01.2008
Bachelor of Liberal Arts - Health Care Mgmt.
University of Toledo
Toledo, OH12.2005
Skills
- Proficient in Microsoft Office (Word, Excel, PowerPoint)
- Proficient in Athena, Cerner, & Newman EMR systems
- Experience with claims processing for Government & Commercial Payers
- Cash Posting
- Electronic Healthcare Billing
- Customer Service
- Team Player
- Denials Mitigation
- CMS Hearing Experience
- Administrative Law Judge Hearing Experience (CMS)
- Medical Record Retrieval
- Computer skills
- Attention to detail
- Problem-solving
- Microsoft Office Suite
Timeline
Assistant Claims Processing
Ascension Medical Group
05.2024 - Current
Financial Counselor II
R1 RCM
01.2016 - 02.2024
Disability Advocate
Accretive Health
01.2011 - 01.2016
Business Office Assistant
Palm Garden of Jacksonville
01.2009 - 01.2011
Accounts Receivable Representative
HCR Manor Care (Corporate)
01.2000 - 01.2008
Dual Masters - Business Administration & Healthcare Management
University of Phoenix
Bachelor of Liberal Arts - Health Care Mgmt.
University of Toledo
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