Dionne Kilgore

Perform insurance and billing clerical duties, including review and maintenance of patient account information.

Resolve routine patient billing inquiries and problems.

Prepare and submit claims to various third parties electronically.

Identify and resolve claim denials.

Act as an liaison between patients and third parties.

Prepare, generate and distribute accurate and timely invoices.

Any and all duties assigned such as responding to emails, phone calls, price quotes, Med D comparisons and adjudication of claims.

Responsible for entering and tracking all daily census and face sheets from Beneficiary facilities for correct billing to Medicare, Medicaid and private insurances.

Contacting the facility on the status of Medicaid pending residents.

Communicate with Business Office Mangers, Directors of Nursing and/or Administrators at the long-term care facilities as needed.

Timely verification and entry of customer information.

Maintain accurate and complete census records concerning patient billing activity.

Meet all census deadlines designated by customer expectations and contractual agreements.

Work and partner with other internal and external departments to resolve issues.

Follow all applicable government regulations including HIPAA.

Other related processes and job duties assigned and adjudication of claims.

I began in the PED department, which is starting an maintaining prior authorizations for Resident's. After one year in this department I quickly moved into the Billing department.

I performed insurance and billing clerical duties, including reviewing and maintaining patient account information.

I resolved routine patient billing inquiries and issues.

I identified and resolved claim denials.

I acted as an liaison between patient and third parties.

I prepared, generated and distributed accurate and timely invoices.

I adjudicated claims, completed check requests for end of month and updated/maintained Medicaid Residents.

Responsibilities primarily included assisting pharmacies with processing information, overrides, long term care claims, prior authorizations as well as a variety of daily obstacles.

Daily functions also involved member related inquiries such as ordering prescriptions through mail order and maintaining/updating personal information for Members.

Other tasks involved documenting notes of action and having a clear understanding of each client policies, procedures and individual needs.

Call center office environment. Summarization to include but not limited to answering bill payment related queries for consumers, conference calls between biller and client, sending correspondence, explanations how payments get processed and periodically sent detailed payment reports to the consumer and/or biller for different purposes.

April 2005, I was internally promoted to the Research Department. Capabilities then included concentrating on outgoing calls for client payments not being received/posted in a timely manner and sending out letters of good faith.

June 2007, I was transferred to a developing Merchant Department. I "lent a hand" to transition a team of peers into this new area by a different type of Customer Service while still reaching and maintaining company goals.

November 2007, I was promoted to Sr. Associate. My achievements increased to include aiding in an "assist line" for peer support, mentoring new and tenure associates from multiple platforms, taking escalated calls, working with the new hires in an academy bay as well as assisting with company procedure.

May 2008, I accepted a Team Lead interim position which emphasized responsibilities to include verbal coaching's, side by side an live monitors on new and seasoned co-workers. Floor walking to support assistance. Frequent meeting with Supervisors and peer Team Leads to strategically focus on agendas and enhancing work performance.