DOMINIQUE WILLIAMS
Port Allen,LA
Summary
Experienced Benefits & Authorization Specialist skilled in insurance billing, claims processing, eligibility determination, and prior authorization procedures. Adept at ensuring compliance with HIPAA regulations and leveraging proficiency in medical terminology and patient coverage assessments to streamline operations. Ready to contribute expertise in insurance validations and benefits administration to drive organizational success.
Overview
14
14
years of professional experience
Work History
Insurance Verification Specialist
Option Care
Port Allen, LA
06.2024 - Current
- Assessed insurance policy terms to determine patient coverage and limitations.
- Verified insurance coverage and eligibility prior to appointments and procedures.
- Reviewed patient deductibles and copays and entered into billing system.
- Addressed and resolved issues identified by billing staff related to eligibility and coverage.
- Processed pre-authorizations for medical services according to established guidelines.
- Calculated estimated patient financial responsibility via estimation tool.
- Utilize different systems and portals to confirm insurance and/or RX plan.
- Run test claims to determine copay for medication to report to pharmacy.
- Demonstrated expertise in verifying insurance coverage and eligibility for patients by utilizing various online databases, phone calls, and other resources.
- Provided timely follow-up on pending requests from multiple sources.
- Collaborated with healthcare providers to resolve discrepancies in patient insurance information.
Patient Account Representative
Professional Service Bureau (PSB)
Port Allen (wfh), LA
11.2023 - 06.2024
- Identified discrepancies between billed charges and payments received from insurance companies.
- Communicated with insurance companies to check claim and payment statuses.
- Researched denied or rejected claims in order to identify errors or omissions that may have caused the denial and rejection.
- Analyzed patient accounts for accuracy and completeness prior to submitting claims to insurance companies.
- Reviewed Explanation of Benefits from insurance companies for accuracy prior to posting payment information into the system.
- Updated payment and personal information in patient database to maintain accurate records.
- Performed detailed reviews of patient financial records ensuring all documents are properly filed according to established procedures.
- Successfully managed incoming calls by providing accurate information regarding payments, balances due, and payment plans.
Invoicing Specialist/Disaster Recovery Specialist
Aptim
Baton Rouge, LA
10.2022 - 11.2023
- Contract!
- Download files from the SharePoint file-sharing program.
- Convert downloaded files to PDF logs using Adobe Acrobat software.
- Audit PDF logs to verify accuracy, auditing for errors, inaccuracies and falsifications.
- Check accuracy in billing for contractors (DSW, CAM, ANVALA, and Excel) to submit to GOHSEP & FEMA.
- Invoice compliance training for GOHSEP & FEMA.
- Utilizing Maintenance Connection & Power BI.
- Enter metadata in SharePoint Complete.
- 100% accuracy in wording and mathematical skills.
- Represent the company with a positive attitude and demeanor.
- Return inaccurate PDF logs to clients for correction and to ensure compliance, when necessary.
- QA of audited logs.
Human Resources Manager/ Independent Dispatcher
360 Transport & Dispatch LLC
Baton Rouge, LA
06.2021 - 05.2023
- Specialize in helping Owner Operator/Businesses grow by finding loads, connecting drivers to with direct shippers, creating dedicated lanes plus more.
- Performing Background checks to qualify suitable drivers
- Weekly payroll for two companies, direct deposit, quarterly payroll tax reports and year end w-2 and 1099’s
- Data entry to quick books & TMS system
- Live chat with contractors
- Manage accounts receivables and remittances
- Pay or make payments via stripe, wire, Ach, and card payments.
- Hiring and inputting paperwork and information in payroll system and company systems
- Bidding on Government Contract (Awarded one)
- Ability to meet deadlines weekly and inputting information for quarterly taxes.
- Any other accounting duties required.
- Designed training programs that improved staff skills and retention rates.
- Conducted compensation analysis to maintain competitive salary structures.
Collections Specialist / Book Keeper
Cocreham Brick & Stone, Inc (Temp)
Baton Rouge, LA
09.2021 - 10.2022
- Collections - Commercial.
- Aging Reports.
- Microsoft Excel.
- Securing payment for delinquent accounts in multiple forms.
- Custom Reporting.
- Debt Reconciliation.
- Negotiated with customers to reach payment agreements.
- Monitored outstanding account balances and determined need for further collections action.
- Worked closely with management to resolve or assist in customer delinquency issues.
- Resolved customer billing issues to expedite cash flow.
- Managed a portfolio of delinquent accounts by utilizing collection strategies and techniques.
- Resolved disputes between customers and creditors quickly and efficiently through effective communication skills.
- Processed manual payments received from customers accurately according to company policy.
- Generated detailed reports summarizing account activity, delinquency trends, collection results.
Accounting Coordinator (Temp)
Submeter One
Baton Rouge, LA
06.2020 - 09.2021
- Responsibilities encompass all accounting and HR functions including payroll, benefits mgmt., A/P, A/R, G/L coding, bank reconciliations, ACH and all financial electronic functions, along with vendor mgmt. and client financial updating in addition to EOM reporting and EOY tax prep and hand off to CPA.
- Coordinate with driver about clients that are due to be cut off.
- Mail Sorting and filing.
- Daily Paperwork overview.
- Supported month-end closing activities by reviewing account balances for accuracy.
Bookkeeper
Guaranty Bank and Trust
New Roads, LA
01.2016 - 06.2020
- Work Bookkeeping emails for debit card or electronic banking apps, etc.
- Debit card orders on New Accounts and reissues.
- Reconcile Debit card clearing account.
- Enfact notices, charge-backs & research debit card issues; monitor ATM/Debit Card for fraud.
- Trained teller.
- Record removal of statused ATM/Debit cards.
- Monitor internet usage report, assist w/ new enrollments & service assist.
- Port Merges.
- Process Wires, Stop Payments, Phone Transfer, Revoked Authorizations.
- SSI reclamations; SSA verifications & Successions.
- Answers phones and help customers with issues dealing with their accounts.
- Scan documents; file & dispose of truncated checks.
- Balance Teller Count Sheets to GL.
- Complete Weekly Reconciliation of ATMs.
- Monitor mobile deposits approve/deny every 2 hours.
- Cross sell different accounts.
- Make credit or debit entries to certain accounts when needed.
- Handle Debit card disputes.
Shift Manager
Pizza Hut Restaurants, Inc
Port Allen, LA
04.2012 - 12.2015
- Delivered excellent customer service.
- Money management.
- Trained staff to deliver outstanding customer service.
- Reconciled transactions and end of day cash.
- Balanced cash drawers and resolved financial discrepancies using receipts and financial documents.
- Addressed customer complaints and resolved conflicts.
- Maintained a safe work environment by enforcing company policies and procedures.
Education
High School Diploma -
Port Allen High School
Port Allen05.2013
Bachelor's - Accounting
Upper Iowa University
Baton Rouge01.2020
Skills
- ACH
- General Ledger Accounting
- Bank Reconciliation
- Outbound Sales
- Account Reconciliation
- Office Management
- Accounts Payable
- Accounts Receivable
- Journal Entries
- Financial Report Writing
- QuickBooks
- Payroll
- Human Resources Management
- Auditing
- Benefits Administration
- Insurance billing
- Medical terminology
- Data security and confidentiality
- Coverage and authorizations
- Patient contact
- HIPAA compliance
- Claims processing
- Prior authorization processing
- Medicaid
- Eligibility determination
- Insurance terminology
- Insurance claim validation
- EPIC
PERSONAL INFORMATION
Willing To Relocate: Anywhere
Timeline
Insurance Verification Specialist
Option Care
06.2024 - Current
Patient Account Representative
Professional Service Bureau (PSB)
11.2023 - 06.2024
Invoicing Specialist/Disaster Recovery Specialist
Aptim
10.2022 - 11.2023
Collections Specialist / Book Keeper
Cocreham Brick & Stone, Inc (Temp)
09.2021 - 10.2022
Human Resources Manager/ Independent Dispatcher
360 Transport & Dispatch LLC
06.2021 - 05.2023
Accounting Coordinator (Temp)
Submeter One
06.2020 - 09.2021
Bookkeeper
Guaranty Bank and Trust
01.2016 - 06.2020
Shift Manager
Pizza Hut Restaurants, Inc
04.2012 - 12.2015
Bachelor's - Accounting
Upper Iowa University
High School Diploma -
Port Allen High School