Open To Work
Donna Poole
Jacksonville,FL
Summary
Achieved high customer satisfaction ratings through proactive problem-solving and support. Drove successful outcomes by aligning service efforts with business objectives. Cultivated strong relationships with clients to enhance loyalty and retention.
Overview
14
14
years of professional experience
1
1
Certification
Education
Certification - Medical Billing & Coding
Sandford Brown College
Jacksonville, FL07.2011
High School Diploma - undefined
Sandalwood High School
Jacksonville, FL06.1985
Work History
Fraud Specialist
FIS GLOBAL/GENPACT
Jacksonville, FL
01.2022 - Current
- Evaluate disputed credit card transactions
- Investigate disputes determine whether there was a fraud and validate the charge back if appropriate.
- Create claims for disputes or fraud charges
- Research Transactions
- Detect Fraud
- Block credit cards after a possible fraud alert
- Create claims for disputes or fraud detection
Medical Office Scheduler
Southeast Orthopedic Specialists
Jacksonville, FL
08.2021 - 01.2022
- Schedules clinic appointments including consultations, and follow-up visits
- Enters all pertinent demographic, insurance and medical information into the practiced EMR.
- Confirms necessary information to allow processing of claims to insurance plans.
- Utilizes templates, scheduling assistant, and referral system to schedule patient appointments.
- Confirms patient is eligible with insurance plan at the time appointment is scheduled.
- Successfully processes referrals through the referral system, contacts patients to schedule appointment and import referrals/documents to patients chart.
- Answers and resolves all incoming calls and requests in a timely, accurate manner. Communicates with the supervisor about potential patient concerns.
- Triages and relays necessary messages to appropriate staff member.
- Ensures strict confidentiality of all health records, member information and meet HIPAA guidelines
Patient Access Representative
Precision Imaging Center
Jacksonville, FL
04.2021 - 08.2021
- Greets and registers patients.
- Responsible to acquire all prior imaging medical records needed to execute radiology imaging dictation.
- Assist with uploading disk, mrn changes and radiology report workflow.
- Supports and back-ups the Imaging Assistant and Imaging Receptionist
- Verifies insurance and demographic information.
- Checks patients in and out and makes appointments as indicated.
- Collects co-pays and patient payments.
- Answers phones.
- Answers basic patient billing questions
- Patient registration
- Scanning documents
- Posting charges and payments
- Assisting patients as needed
- Assists with some financial counseling duties as needed
Customer Service Representative
GOTTLIEB MEDICAL BILLING
Jacksonville, FL
09.2020 - 04.2021
- Answer Incoming calls from patients receiving statements from their insurance
- Receive payments and post amounts paid to patients accounts.
- Answer patients questions regarding if the claim were filed to their insurance with their eob.
- Go over options about financial status of patients account and status of collection efforts.
- Facilitation of insurance billing and collection.
- Following patient accounts through the billing process to the payor.
- Working with the payor through claims processing.
- Ensuring reimbursement to the practice
- Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections.
- Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
- Determining the status of claims with the insurance company, if the claim meets contractual agreements or needs adjustment
- Obtain medical records and collect needed documents from insurance companies
- Reconcile account balances, and verify monies are applied correctly
- Interpret terms for Managed Care, Commercial, Medicare, Medicaid and Workers' Compensation when applicable
- Obtain account information through insurance companies and patient contacts.
- Obtains and attaches referrals/authorizations to appointments/charges
- Reviewing EOBs and reconciling claims.
- Excellent communication skills and strong computer skills
Customer Service
Bank of America Financial Center
Jacksonville, FL
01.2016 - 04.2016
- Keep records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken.
- Review insurance policy terms to determine whether a particular loss is covered by insurance.
- Determine charges for services requested, collect deposits or payments, or arrange for billing.
- Check to ensure that appropriate changes were made to resolve customers' problems
Collector Specialist
PNC Mortgage
Jacksonville, FL
01.2012 - 04.2015
- Receive payments and post amounts paid to customer accounts.
- Confer with customers by telephone or in person to determine reasons for overdue payments and to review the terms of sales, service, or credit contracts.
- Locate and monitor overdue accounts, using computers and a variety of automated systems.
- Answer customer questions regarding problems with their accounts.
- Record information about financial status of customers and status of collection efforts.
- Negotiate credit extensions when necessary.
- Arrange for debt repayment or establish repayment schedules, based on customers' financial situations.
Skills
Utilized critical thinking skills to assess complex problems and formulate effective solutions
Spearheaded negotiation processes to secure mutually beneficial agreements
Facilitated critical judgment and decision-making processes to advance strategic initiatives
Streamlined task scheduling and prioritization to maximize productivity
Conducted thorough analysis to identify and address complex challenges
Designed and executed innovative learning strategies to improve educational outcomes
Implemented troubleshooting procedures to diagnose and rectify technical issues
Managed medical billing operations to guarantee precise and prompt claims submission
Administered insurance verification processes to guarantee precise patient billing
Input data into systems with precision and speed Help maintain organized records for quick access Assist team members by providing regular updates on data entry status
Managed computer operations to guarantee uninterrupted functionality
Executed thorough documentation reviews to guarantee accuracy and compliance standards
Directed daily operations within a medical office to ensure efficient workflow
Oversaw front desk operations to ensure seamless patient check-in and appointment scheduling
Assisted in organizing medical records for easy access Supported healthcare teams by documenting patient information accurately Helped process medical records requests in a timely manner
Assisted in managing electronic medical record systems to improve patient data access Supported healthcare teams in using EMR systems for enhanced patient care Aided in training staff on EMR functionalities to boost operational efficiency
Processed customer invoices and payments with precision Assisted in organizing accounts receivable records Supported team in addressing billing discrepancies effectively
Assisted in coding procedures to ensure accurate billing and documentation Supported healthcare teams in comprehending CPT coding guidelines Aided in maintaining compliance with coding standards
Cultivated expertise in medical terminology to facilitate effective communication among healthcare teams
Implemented medical coding processes to guarantee precise billing and adherence to healthcare regulations
Assisted in categorizing medical diagnoses with ICD-9 codes Supported healthcare teams in keeping patient records accurate Helped organize medical data for easy access
Utilized extensive anatomy expertise to improve educational effectiveness
Assisted in upholding HIPAA regulations to safeguard patient information Supported teams in executing privacy policies and procedures Helped train staff on HIPAA requirements and best practices
Assisted customers with inquiries to improve satisfaction Helped resolve product-related issues Supported communication between customers and service teams
Assisted with data entry and analysis using Microsoft Excel Supported team members in developing spreadsheets for project tracking Helped keep records organized for easy data retrieval
Assisted users in utilizing Microsoft Word features effectively Supported formatting and editing of documents Aided teams in collaborating on shared documents
Assisted in categorizing medical diagnoses with ICD-10 codes Supported healthcare teams in keeping patient records accurate Aided in organizing coding documentation for compliance requirements
Assisted in scheduling medical appointments for patients Supported healthcare providers in organizing daily schedules Helped facilitate communication between patients and medical staff regarding appointment information
Assisted in processing workers' compensation claims to facilitate employee recovery Supported maintenance of accurate records for claims and communications Guided employees on benefits and procedures
Employed medical terminology to facilitate effective communication among healthcare professionals
Assisted in identifying fraud risks through careful transaction monitoring Supported teams in executing fraud detection strategies to reduce losses Aided in conducting training sessions on fraud prevention techniques for staff members
Utilized extensive anatomy expertise to elevate educational program quality
Assisted in processing medical claims for prompt reimbursement Supported patients with billing questions to improve satisfaction Collaborated with healthcare providers to maintain accurate coding and billing practices
Streamlined clerical operations to enhance overall office efficiency
Assisted guests with check-in and check-out procedures Provided details regarding hotel amenities and nearby attractions Supported front desk functions by handling phone calls and managing reservations
Enhanced understanding and application of medical terminology in clinical settings
Leveraged comprehensive anatomy knowledge to enhance educational programs
Assisted in processing medical claims for timely reimbursement Supported patients with billing inquiries to enhance satisfaction Collaborated with healthcare providers to ensure accurate coding and billing practices
Medical terminology
Anatomy knowledge
Medical billing
Certification
- CNA/MED TECHNICIAN February 2019 to March 2019
- CPR Certification
- BLS Certification
CUST
- Willing to relocate to: Orlando, FL - Tampa, FL - Jacksonville, FL - Daytona Beach, FL
- Authorized to work in the US for any employer
Work Preference
Work Type
Full TimeLocation Preference
RemoteOn-SiteHybridTimeline
Fraud Specialist
FIS GLOBAL/GENPACT
01.2022 - Current
Medical Office Scheduler
Southeast Orthopedic Specialists
08.2021 - 01.2022
Patient Access Representative
Precision Imaging Center
04.2021 - 08.2021
Customer Service Representative
GOTTLIEB MEDICAL BILLING
09.2020 - 04.2021
Customer Service
Bank of America Financial Center
01.2016 - 04.2016
Collector Specialist
PNC Mortgage
01.2012 - 04.2015
Certification - Medical Billing & Coding
Sandford Brown College
High School Diploma - undefined
Sandalwood High School