Deborah Wilson
Remote, Reconciliation Analyst
Greensboro,NC
Summary
Well-regarded Professional who combines 15+ years of medical records handling, supervisory, documentation, billing reconciliation, and account management experience with another 25+ years of cross-functional Customer Service Skills to Illustrate Value, Customer Focus, Adaptability, Competency and Teamwork. Possess a Growth Mindset, Persistence, Personal Responsibility and Future Orientation. Follow Policies, Procedures, and Guidelines to Ensure Consumer receives Quality Service. Attention to detail necessary to ensure the quality of documentation in patient medical records. Communication skills necessary to effectively deal with patients and healthcare providers. Well-organized, manages time and priorities in multi-task environments. Stay on top of accounting needs by proactively updating journal entries, financial schedules and budget tracking reports. Diligent accounting and office administrative professional with over 40 years of experience in Professional settings. Highly organized, hardworking and accuracy-driven. Hardworking and reliable Reconciliation Analyst with strong ability in Triage/Scrub Consumer Files for Errors. Offering Critical Thinking and Analytical Skills. Highly organized, proactive and punctual with team-oriented mentality.
Overview
40
40
years of professional experience
1
1
AHS Medical Billing & Coding
1
1
Healthcare Information Technology
Work History
Reconciliation Analyst
Insurance, WiPro Limited
, NC
02.2022 - Current
- A reconciliation analyst is responsible for resolving transaction discrepancies between institutions, especially in financial and business records
- Reconciliation analysts conduct audits on reports to identify gaps and inconsistencies and escalate it to the reconciliation supervisor for resolution recommendation
- They also review account statements, update information on the database, and coordinate with other departments for the necessary filing of documents
- A reconciliation analyst must have excellent analytical and critical-thinking skills, especially in providing immediate solutions to clients by adhering to the company's requirements and regulations
- Manage daily/semi-daily installation of PL/SQL packages and configuration scripts from test environment to end-user environment
- Add new trading partners to EDI
- Utilize the Internet for data as needed
- Respond to all correspondence via written or verbal communication, within DOD timeframe
- Develop SQL scripts that improve the efficiency of processes, analysis, and reporting
- Use SQL to execute correct information for members and providers daily by utilizing queries
- Reconcile tax deposits to payroll reports daily, weekly, monthly, and quarterly
- Process check requests, wires, and ACH payments using EFT system on a daily basis
- Work out of different data bases to enroll new policy holders during health enrollment for Medicaid and Medicare
- Organize interactions, which solve problems and issues between the partner's interface system and
- PFPC's portfolio system
- Analyze future software systems for full transition of ACH processing and ATM processing from the third-party service provider
- Schedule and process conversion transactions for mid-market clients at one of the largest payroll and tax-filing processors in the world
- Reconcile income assets to ensure proper and timely posting of dividends, interest, long term, and short capital gains
- Estimate and examine final statements connect to debtors' assets, income and employment history in order to decide ability to pay
- Provide management with monthly Medicaid revenues and other financial results to be report to the accounting department for month end close.
Episodic Revenue Cycling Specialist
Advanced Home Health
High Point, NC
08.2021 - 01.2022
- Review, Triage, Void/Correct & Submit All Non-Medicare Episodic Claims for Mississippi, North Carolina,
- Tennesse & Virginia Locations for VA Optum, TriCare, TriWest, TriEast, Aetna MA HMO/PPO, Bright Health
- Commercial, Humana MA HMO/PPO, WellCare MA HMO, UHC MA HMO, Amerigroup Amerivantage, BCBS
- Blue Advantage & BCBS OOS Blue Advantage
- Client Services such as Hospital, Rehab, Occupational
- Therapy & Skilled Nursing & Clinician interactions
- Triage claims for Coding Errors/Corrections, Verify &
- Validate EOB/Prior Authorizations for Accuracy
- Verify Referrals to Match SOC/DOS Information on Claims
- Submitted.
Virtual Call Center Supervisor/Trainer
Maxmius Federal & The Center for Disease Control
, NC
04.2021 - 08.2021
- Worked successfully on a Startup Project with Maximus Federal and the CDC as Virtual Call Center
- Supervisor as well as a Trainer
- Independently helped build out systems to be put in place to help target the Agents on my team as well as others to ensure they were properly engaged through Social Engineering Processes as well providing
- Customer Service that meet standards and were Customer Focused in nature
- Impactfully provide support for my team on a rapid-launch project with little lead up for the initial preparation of Agents by providing a Strategy surrounding Training classes and materials when system access was available
- As well as fostering a Teamwork mentality and environment among remote Agents
- Responsible for Managing, Coaching and Auditing a team of 55 Agents providing direct Customer
- Support on a new project contracted with the CDC as well as Managing Building Teams during a
- Remote Position
- Ensured Agents were using correct equipment and Operating System to operate Project
- Software and acted as Technical Support to ensure systems issues were resolved before involving IT
- QA Scored, Monitor and present Call Coaching to Agents after calls in order to work towards providing
- Resolution on the First Call from the Citizen including providing Kudos where needed and direct offers of Coaching towards Improvement when needed
- Remained Flexible and ensured Professionalism even in a Remote Environment
- Working to ensure
- Agents and have support when questions on calls or system issues arise to be a direct resource to ensure that they were successful on the Calls; as well increase the success and efficiency of the project itself
- Independently helped build out systems to be put in place to help target the Agents on my team as well as others to ensure they were properly engaged through Social Engineering Processes as well as providing Customer Service that meet standards and were Customer Centric in nature
- Impactfully supported my Team in what began as a rapid-launch project with little lead up for the initial preparation of Agents by providing an atmosphere of teamwork during a remote work position
- Successfully coordinated and completed Training sessions that assisted in coaching and providing the support that was needed for a rapid launch program for over 200 Agents on Systems usage and skills that set them up for success for the project
- Supported My Two Fellow Trainers Collaborating to set up new training for Agents that was utilized by many Supervisors and Operations Managers after Senior Management was informed of the thoroughness of the curriculum
- As well as how successful it was in implementation an increase of the consistency and quality of the Agents work that attended the training classes
- Provided real-time hands-on experience for Agents that may have been limited in the access to systems before coming onto the production floor through Training, Coaching, and direct Supervision with my
- Team
- Utilized my expert knowledge base in Quality Control related to Customer Contact to provide support for Agents so that we could achieve high-quality Scores, meeting KPI Standards and achieve the vision set in place regarding the project Goals and Leadership’s Values.
Patient Healthcare Screener
Alamance Regional Medical Center Cone Health Systems
Greensboro, NC
10.2020 - 04.2021
- Handle inbound telephone calls to contact the clinical staff
- Consult with clients and patients regarding medical history updates
- Check temperatures to ensure the safety of employee's and other personnel entering and leaving the facility
- Understand and abide by HIPAA regulations and maintain patient confidentiality.
Medical Records Risk Auditor
CIOX Health
Greensboro, NC
05.2017 - 10.2020
- Traveled throughout the United States to hospitals, medical facilities, and specialty practices to scan medical records at various provider offices
- Pulled records from assigned patient list to conduct internal audits to verify the accuracy of demographics, billing, and dates of service information
- Accessed and identified information within medical record using a variety of EMR and EHR programs
- Printed, scanned, copied, indexed, assembled, and uploaded to health information cloud for final assessment
- Accurately and efficiently conducted medical record review services
- Ability to store all PHI/Client personal information in a secure manner to prevent hacking or phishing
- Able to use internet security software and protocols to keep all private information safe.
Health Information Management / Medical Records Specialist
STEP BY STEP, INC
Greensboro, NC
03.2020 - 08.2020
- Triaged outpatient Therapy (OPT) notes using Checkpoint EHR to ensure accuracy of information
- Communicated with administrative team regarding changes and followed up to make sure changes were made
- Verified that services provided were parallel with the information in the system to ensure accurate billing
- Conducted internal audits and received, entered, and updated patient data and information
- Received, completed, and documented Release of Information (ROI) requests
- Monitored documentation input for accuracy and protected patient privacy and confidentiality
- Ability to store all PHI/Client personal information in a secure manner to prevent hacking or phishing
- Able to use internet security software and protocols to keep all private information safe.
New Business Coding Associate / Customer Service
Lincoln Financial Group
Greensboro, NC
04.2017 - 03.2018
- Processed claims, developed, implemented, and sought policy improvement, and handled reconciliations
- Completed billing and reimbursements, collected on past due amounts, and provided customer service
- Confirmed compliance with industry standards, regulations, and company policies and procedures.
Tele-App Specialist / Customer
Lincoln Financial Group
Greensboro, NC
09.2016 - 04.2017
- Scheduled and conducted phone interviews to obtain information to complete life insurance application documents
- Communicated with other departments, collaborated medical exams, and scheduled follow-up calls
- Ensured items were addressed quickly and provided ongoing updates and communication to participants.
Supervisor / Habilitation Technician
Mercy Home Services
Greensboro, NC
11.2012 - 08.2016
- Developed and reinforced documentation and communication and implemented and communicated policies
- Provided training, adhered to federal and state policies for group homes, and oversaw provision of services
- Communicated and partnered with interdisciplinary team of pharmacists and physicians on behalf of residents.
Housing Specialist
Integral Resource Center BKA IRC
Greensboro, NC
06.2013 - 03.2016
- Assessed housing barriers and developed housing procurement, financial, and self-sufficiency case management plans for My Clients.
Disability Specialist
The Servant Center
Greensboro, NC
03.2012 - 12.2015
- Determined eligibility for assistance and benefits, ensured accuracy of documentation, and helped with appeals for Homeless Veterans to Help them activate their VA Benefits
- Also helped with the SSI/SSDI
- Benefit Application Process for our Disabled Vets.
Accounts Payable / Receivable Clerk
Tyco / Simplex Grinnell
High Point, NC
08.2008 - 11.2012
- Provided financial, administrative and clerical services to ensure effective, accurate administrative operations
- Followed policies, processed vendor invoices, and completed and scheduled check and refund requests
- Answered inbound phone calls, coordinated mail, and reviewed vendor statements and balances for accuracy.
Call Center Supervisor / Customer Service
Integral Resources, Inc
Raleigh, NC
06.2007 - 04.2010
- Placed outbound calls to raise money for political campaigns
- Supervised and monitored calls to ensure adherence to FCC regulations and standards
- Completed work in a timely and accurate manner and protected individual privacy and confidentiality.
International Concourse Supervisor / Customer Service
Delta Airlines
Raleigh, NC
05.2000 - 07.2007
- Supervised cleaning and servicing crew of 30 employees and scheduled and coordinated customer reservations
- Served as liaison for United States Customs to help passengers with re-entry back into the country
- Ran background checks for new employees, and ensured passengers boarded flights in a timely and orderly manner.
Education
Diploma of Completion - Healthcare Information Technology, Health Science
Fayetteville Technical Community College
Fayetteville, NC06.2023
Associate of Science - Medical Billing & Coding
Ultimate Medical Academy
Tampa, FL01.2018
Skills
- Microsoft Office Applications - MS Word, MS PowerPoint, MS Excel, MS Outlook; Oracle
- Typing Speed: 65 WPM / Data Entry 10-Key: 5846 KSPM
- Electronic Medical Records (EMR) / Electronic Medical Records (EHR) Software
- Epic Cloud-Based EHR
- Greenway EHR gGastro Suite EMR
- Allscripts EHR
- Allscripts Pro EHR
- NextGen EHR
- MedPointe EHR
- EClinicalWorks EHR
- Kareo EMR
- Medisoft EMR
- Aprima Prime Suite EHR
- Checkpoint EHR
- Centricity EMR
- Quantum Quest EHR
- MBC
- TalkEHR
- CRM
- CRM/GENESYS Interface
- GENESYS Platform
- Kinnser/Well Sky EMR/Billing
- System
- Way Star ERM/Billing System
- Skills
- Medical Billing
- Medical Office
- Medical Administrative
- Patient Registration
- Medical Records Management/Coordinator (10 years)
- Payment Posting
- Denials
- Appeals
- Referrals
- Accounts Receivable Healthcare Payers
- PTSD Care
- Hospitality
- Customer service
- Documentation review
- Employee Orientation
- Spanish
- Intermediate
- CRM Software
- CRM/GENESYS INTERFACE
- Laboratory Experience
- Management
- Negotiation
- Project management
- Medical terminology
- Medical collection
- SAP
- Google Suite
- Social work
- Military
- Behavioral health
- Medical documentation
- Windows
- Leadership
- Computer skills
- Microsoft Office
- Hospital experience
- Microsoft Excel
- Kinnser/Well Sky EMR System (Less than 1 year)
- Way Star EMR Billing System (Less than 1 year)
- Superbill
- SPANISH
- Intermediate https://wwwlinkedincom/in/deborah-wilson
- Data collection
- Recruiting
- LAN
- EDI
- Content management systems
- Oracle
- Links
- Https://wwwlinkedincom/in/deborah-wilson-37258138
- Https://wwwlinkedincom/in/deborah-wilson-37258138?lipi=urn%3Ali%3Apage
- Certifications and Licenses
- BLS Certification
- CPR Certification
- Assessments
- Verbal communication — Highly Proficient
- March 2020
- Speaking clearly, correctly, and concisely
- Full results: Highly Proficient
- Medical billing — Familiar
- February 2020
- Understanding the procedures and forms used for medical billing
- Full results: Familiar
- Attention to detail — Proficient
- December 2021
- Identifying differences in materials, following instructions, and detecting details among distracting
- Information
- Full results: Proficient
- Call center customer service — Proficient
- October 2020
- Applying customer service skills in a call center setting
- Medical terminology — Familiar
- August 2021
- Understanding and using medical terminology
- Working with MS Word documents — Completed
- Knowledge of various Microsoft Word features, functions, and techniques
- Full results: Completed
- Customer focus & orientation — Familiar
- June 2021
- Responding to customer situations with sensitivity
- Medical receptionist skills — Proficient
- Managing physician schedules and maintaining accurate patient records
- Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued
- Development in any professional field
- Reconciling Accounts
- Financial Calculation and Analysis
- Financial Research
- Precision and Accuracy
- Record Reconciliation
- Account Auditing
- Critical Thinking
- Data Analysis
- Data Entry
- CRM Tracking
- Attention to Detail
- Accounts Receivable
- Account Audits
- 5826 Kph
- Creative Problem Solving
- Vendor Relationships
- Compliance Software
- Complaint Resolution
Certification
CMS 1500 Claim Form
Medicare / Medicaid Process (10+ years)
Medical Records Coordination (10+ years)
Third Party Payers Managed Care (HMO, PPO, POS)
ICD-9-CM
ICD-10-CM Coding
Introduction to CPT Coding HIPAA Compliance
Medical Charts
Basic Anatomy & Physiology (10+ years)
Healthcare Settings Insurance Verification
Reimbursement Systems
Healthcare Claim Cycle
Medical Terminology (10+ years)
Allscripts (5 years)
eClinicalWorks (5 years)
Accounting (10+ years)
Triage (10+ years)
EMR Systems (5 years)
Medical Transcription (10+ years)
Medical Coding
Nursing (4 years)
Cybersecurity (10+ years)
Experience Administering Injections (10+ years)
Vital Signs (10+ years)
Phone Etiquette (10+ years)
Epic (10+ years)
Clerical Experience (10+ years)
Quality Assurance (10+ years)
Medical Scheduling (10+ years)
QuickBooks (10+ years)
Auditing (5 years)
Cerner
Additional Information
- Authorized to work in the US for any employer
Languages
English
Full Professional
Spanish
Limited
Affiliations
- National Member of Who's Who of Professional Women Since 2008
- National Member of Canterbury Professional Women's Association Since 2012
- Member, Ultimate Medical Academy Alumni Association
- Member, National Chapter of Zeta Phi Beta, Inc
Timeline
Reconciliation Analyst
Insurance, WiPro Limited
02.2022 - Current
Episodic Revenue Cycling Specialist
Advanced Home Health
08.2021 - 01.2022
Virtual Call Center Supervisor/Trainer
Maxmius Federal & The Center for Disease Control
04.2021 - 08.2021
Patient Healthcare Screener
Alamance Regional Medical Center Cone Health Systems
10.2020 - 04.2021
Health Information Management / Medical Records Specialist
STEP BY STEP, INC
03.2020 - 08.2020
Medical Records Risk Auditor
CIOX Health
05.2017 - 10.2020
New Business Coding Associate / Customer Service
Lincoln Financial Group
04.2017 - 03.2018
Tele-App Specialist / Customer
Lincoln Financial Group
09.2016 - 04.2017
Housing Specialist
Integral Resource Center BKA IRC
06.2013 - 03.2016
Supervisor / Habilitation Technician
Mercy Home Services
11.2012 - 08.2016
Disability Specialist
The Servant Center
03.2012 - 12.2015
Accounts Payable / Receivable Clerk
Tyco / Simplex Grinnell
08.2008 - 11.2012
Call Center Supervisor / Customer Service
Integral Resources, Inc
06.2007 - 04.2010
International Concourse Supervisor / Customer Service
Delta Airlines
05.2000 - 07.2007
CMS 1500 Claim Form
Medicare / Medicaid Process (10+ years)
Medical Records Coordination (10+ years)
Third Party Payers Managed Care (HMO, PPO, POS)
ICD-9-CM
ICD-10-CM Coding
Introduction to CPT Coding HIPAA Compliance
Medical Charts
Basic Anatomy & Physiology (10+ years)
Healthcare Settings Insurance Verification
Reimbursement Systems
Healthcare Claim Cycle
Medical Terminology (10+ years)
Allscripts (5 years)
eClinicalWorks (5 years)
Accounting (10+ years)
Triage (10+ years)
EMR Systems (5 years)
Medical Transcription (10+ years)
Medical Coding
Nursing (4 years)
Cybersecurity (10+ years)
Experience Administering Injections (10+ years)
Vital Signs (10+ years)
Phone Etiquette (10+ years)
Epic (10+ years)
Clerical Experience (10+ years)
Quality Assurance (10+ years)
Medical Scheduling (10+ years)
QuickBooks (10+ years)
Auditing (5 years)
Cerner
Diploma of Completion - Healthcare Information Technology, Health Science
Fayetteville Technical Community College
Associate of Science - Medical Billing & Coding
Ultimate Medical Academy
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