Donna Douville
Customer Service
Oklahoma City,OK
Summary
In the past, I have worked with Temporary Agencies to help gain employment and further my experience in multiple fields , while utilizing my experience and skills
Gifted in working with stressed, confused and upset individuals in need of benefits information.. Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation.
An established Insurance Verification Specialist known for handling various office tasks with undeniable ease. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires, ad providing customized solutions to build loyalty. Dedicated Customer Service professional with knowledge of service delivery and proven multitasking abilities. Committed to maintaining professional relationships to increase profitability and drive business results.
Overview
8
8
years of professional experience
Work History
Claims Techician
HCSC
Oklahoma City, OK
03.2024 - Current
- Evaluated and settled complex insurance claims in strict timeframes.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Verified client information by analyzing existing evidence on file.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Coordinated with contracting department to resolve payer issues.
- Generated, posted and attached information to claim files.
- Determined appropriateness of payers to protect organization and minimize risk.
Customer Care Advocate
Robert Half Employee Healthcare Direct
Dallas, TX
03.2023 - 06.2023
- Answered customer inquiries via phone, email, and online chat.
- Provided technical support to customers regarding product usage and troubleshooting issues.
- Resolved customer complaints in a timely manner while maintaining high levels of customer satisfaction.
- Verified patient information, including medical history and insurance coverage, to ensure accuracy of coding and billing.
- Submitted claims electronically to insurance companies in accordance with regulations.
- Assigned appropriate codes using ICD-10-CM for diagnosis, CPT for procedures, HCPCS for supplies and modifiers as required by payers.
- Provided customer service support via phone or email regarding account balances or other inquiries related to billing issues.
Claims Processor
Sutherland Global
Dallas , TX
04.2022 - 08.2022
- Reviewed and verified insurance policy information to assess coverage and determine appropriate claims processing procedures.
- Analyzed and evaluated claim forms, medical reports, bills, and other documents to ensure accuracy of data.
- Processed a high volume of incoming claims in accordance with established policies and procedures.
Billing Specialist
Spectrum
Irving , TX
10.2021 - 01.2022
- Answered customer inquiries and provided accurate information regarding products and services.
- Assisted customers with product selection, ordering, billing, returns, exchanges and technical support.
- Maintained detailed records of customer interactions, transactions and comments for future reference.
- Demonstrated excellent communication skills in resolving product and consumer complaints.
Insurance Verification Specialist
Alliance Rx Walgreens Prime Specialty Pharmacy
Irving , TX
09.2018 - 09.2019
- Reviewed medical records to ensure accuracy of required information needed for pre-authorization requests.
- Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers.
- Maintained accurate documentation on all pre-authorization requests, denials and appeals.
- Developed a working knowledge of insurance plans, including Medicare and Medicaid regulations and requirements.
- Identified discrepancies in patient's insurance coverage or benefits, ensuring accuracy of data entered into system.
Social Media Specialist
Volt Workforce Solutions 247 inc
Plano, TX
04.2018 - 07.2018
- Developed and implemented social media strategies to increase brand awareness and engagement.
- Created, edited, and managed content for various social media platforms including Facebook, Twitter, Instagram, LinkedIn, YouTube.
- Directed social media and digital marketing strategy and initiatives to promote brand building, guest retention and revenue-focused activities.
- Utilized Twitter and Facebook to promote products, services and content.
- Managed customer service requests through social media channels.
Customer Service Collections Representative
Iqor
Plano , TX
09.2016 - 02.2017
- Answered customer inquiries regarding account balances and payment histories.
- Responded to customer requests for assistance with billing issues.
- Processed payments received by customers in a timely manner.
- Assisted customers with setting up payment plans when necessary.
- Developed relationships with customers to build trust and loyalty.
- Documented all customer interactions into the company database accurately.
- Created reports on collections activity, delinquency trends, and other relevant data points.
- Communicated regularly with internal departments regarding collection updates.
- Advised customers on proper use of their accounts as well as any available discounts or promotions.
Education
Bachelor of Science - Medica Billing And Coding
Ultimate Medical Academy - Clearwater
Clearwater, FL05.2015
Skills
- Customer Service
- Appointment Scheduling
- Database Research
- Data Entry
- Claims Review
- Insurance Claim Forms Review
- Eligibility Determination
Timeline
Claims Techician
HCSC
03.2024 - Current
Customer Care Advocate
Robert Half Employee Healthcare Direct
03.2023 - 06.2023
Claims Processor
Sutherland Global
04.2022 - 08.2022
Billing Specialist
Spectrum
10.2021 - 01.2022
Insurance Verification Specialist
Alliance Rx Walgreens Prime Specialty Pharmacy
09.2018 - 09.2019
Social Media Specialist
Volt Workforce Solutions 247 inc
04.2018 - 07.2018
Customer Service Collections Representative
Iqor
09.2016 - 02.2017
Bachelor of Science - Medica Billing And Coding
Ultimate Medical Academy - Clearwater
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