DENISE M. LUNDY
Coatesville,Pennsylvania
Summary
Competent Accounts Receivable Specialist bringing 20 plus years of experience handling accounts receivable functions. Exemplary skill in resolving billing disputes, providing excellent customer service and applying payments. Recognized for effective leadership with consistent achievement of objectives.
Overview
29
29
years of professional experience
Work History
Collections Specialist
Fresenius Medical Care NA
01.2023 - Current
- Responsible for collecting, posting and managing account payments
- Responsible for submitting claims and following up with insurance companies
- Essential functions of the position include the following:
- Upload claims from Emdeon
- BILL out claims, work rejection in Emdeon
- Run Aging Report, Month End Close Report, Billing Report;
- Obtain authorization when claims are denied for no authorization;
- Obtain contract from insurance payor so claim can be paid at the correct rate
- Answer patient calls on a live phone system
- Call Insurance to f/u on denied claims
- Working Waystar Address rejection.
- Worked in call center environment handling manual and automatically dialed outbound calls.
- Maintained high volume of calls and met demands of busy and productive group.
- Processed payments and applied to customer balances.
- Delivered exceptional customer service on collection calls and maintained calm and professional demeanor.
- Researched accounts and completed due diligence to resolve collection problems.
- Negotiated to collect balance in full.
Customer Service Representative
Azura Vascular Care
Malvern, PA
01.2019 - 01.2023
- Responsible for collecting, posting and managing account payments
- Responsible for submitting claims and following up with insurance companies
- Essential functions of the position include the following:
- Validated denial reason on Explanation Of Benefits (EOB), Verifying Trends or Issues;
- Escalating Payment Variance Trends or issues on underpaid claims;
- Researched contract terms/ interpretation and compile supporting documentation appeal;
- Reviewed Managed Care Contracts; verified insurances were paying according to con
- Escalated exhausted follow up trends to supervisor for resolution; and
- Worked on various projects as directed by supervisor.
- Provided primary customer support to internal and external customers.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Answered constant flow of customer calls with minimal wait times.
- Updated account information to maintain customer records.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Responded to customer requests for products, services, and company information.
- Participated in team meetings and training sessions to stay informed about product updates and changes.
- Developed customer service policies and procedures to meet and exceed industry service standards.
- Utilized customer service software to manage interactions and track customer satisfaction.
- Handled customer inquiries and suggestions courteously and professionally.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Clarified customer issues and determined root cause of problems to resolve product or service complaints.
- Analyzed customer service trends to discover areas of opportunity and provide feedback to management.
Accounts Receivable Specialist
Azura Vascular Care
Malvern, PA
11.2014 - 12.2018
- Responsible for gathering and processing information needed to complete medical insurance claims
- In addition to processing routine claims, responsible for investigating pending claims and resolving discrepancies
- Essential functions of the position include the following:
- Telephone Techniques
- CMS-1500
- Insurance Verification
- Patient Demographics
- Patient Account Analysis
- Electronic Insurance Claims
- Claim Auditing
- Claim Resubmission
- Computerized Billing
- Reviewed accounts on monthly basis to assess aging and pursue collection of funds.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Reconciled accounts receivable ledger to verify payments and resolve variances.
- Prepared and mailed invoices to customers, processed payments, and documented account updates.
Registrar
Brandywine Hospital
Coatesville, PA
01.2010 - 11.2014
- Discharging patients after being seen by doctor by giving all info to patient.
- Generated medical reports on patient admissions, treatment and discharge for disbursement to various departments.
- Performed regular quality and validation assessments on patient data to verify accuracy.
- Greeted every guest with personable approach and provided knowledgeable service.
Health Claims Specialist
Children’s Hospital of Philadelphia
Philadelphia, PA
01.2002 - 01.2010
- Essential functions of the position include the following:
- Identifying and resolving issues for various payers to improve organizational revenue; and
- Working paper edits that have been made at the front office and would not clear with the clearinghouse.
- Communicated verification and authorization status updates with [Type] department to facilitate decision-making for patient admissions and insurance coverage.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Generated, posted and attached information to claim files.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Responded to correspondence from insurance companies.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Managed large volume of medical claims on daily basis.
- Paid or denied medical claims based upon established claims processing criteria.
- Reviewed provider coding information to report services and verify correctness.
- Followed up on denied claims to verify timely patient payment and resolution.
- Monitored and updated claims status in claims processing system.
- Identified and resolved discrepancies between patient information and claims data.
- Researched and resolved complex medical claims issues to support timely processing.
- Processed insurance payments and maintained accurate documentation of payments.
- Assessed medical claims for compliance with regulations and corrected discrepancies.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Generated reports on medical claims processing activities and results.
- Verified patient insurance coverage and benefits for medical claims.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
Health Claims Specialist
Otolaryngology Consultants
Wilmington, DE
01.2001 - 01.2002
- Responsible for gathering and processing information needed to complete medical insurance claims
- Responsible for taking inbound customer service calls and making outbound calls to patients and health care providers
- In addition to processing routine claims, responsible for investigating pending claims and resolving discrepancies
- Essential functions of the position include the following:
- Responsible for coding various charts that were received from the provider post- operatively; and
- Collecting and totaling all super bills to be ensure accuracy
Payment Posting Specialist/Customer Service Representative
Practicare
Malvern, PA
01.1994 - 01.2001
- Responsible for posting cash and working with Medicaid, Medicare, and private insurance companies
- Essential functions of the position include the following:
- Responsible for posting payments to patient’s accounts received from third party payers;
- Update patient insurance information in the customer call center; and
- Charge dispute resolution.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
- Assisted with billing inquiries and provided timely responses to enhance customer satisfaction.
- Processed and verified invoices to secure accuracy of billing information.
- Identified payment trends and adjusted billing processes accordingly to retain customers.
- Prepared and submitted monthly billing reports to management for financial overview.
- Provided excellent customer service, developing and maintaining client relationships.
- Worked with multiple departments to check proper billing information.
- Researched and resolved billing discrepancies to enable accurate billing.
- Reviewed and reconciled customer accounts to manage accuracy of payments.
Education
Study/Skills: Medical Terminology Anatomy Billing Coding -
Harris School of Business
Computerized Billing Simulation HIPAA Compliance - undefined
Timeline
Collections Specialist
Fresenius Medical Care NA
01.2023 - Current
Customer Service Representative
Azura Vascular Care
01.2019 - 01.2023
Accounts Receivable Specialist
Azura Vascular Care
11.2014 - 12.2018
Registrar
Brandywine Hospital
01.2010 - 11.2014
Health Claims Specialist
Children’s Hospital of Philadelphia
01.2002 - 01.2010
Health Claims Specialist
Otolaryngology Consultants
01.2001 - 01.2002
Payment Posting Specialist/Customer Service Representative
Practicare
01.1994 - 01.2001
Study/Skills: Medical Terminology Anatomy Billing Coding -
Harris School of Business
Computerized Billing Simulation HIPAA Compliance - undefined
Similar Profiles
Trina StanleyTrina Stanley
Executive Administrative Assistant at Fresenius Medical Care NAExecutive Administrative Assistant at Fresenius Medical Care NA
Amy JohnsonAmy Johnson
Certified Clinical Hemodialysis Technician at Fresenius Medical Care NACertified Clinical Hemodialysis Technician at Fresenius Medical Care NA
Monise FlintroyMonise Flintroy
Hemodialysis Registered Nurse at Fresenius Medical Care NAHemodialysis Registered Nurse at Fresenius Medical Care NA
Rhonda FoxRhonda Fox
Clinical Manager at Fresenius Medical Care NAClinical Manager at Fresenius Medical Care NA
Terry LambertTerry Lambert
Manual Machinist at Vulcan Spring & Mfg.Manual Machinist at Vulcan Spring & Mfg.