Elizabeth Frensdorff
Southington,CT
Summary
Detail-oriented Revenue Cycle Billing Specialist with proven efficiency in claim processing, insurance verification, and HIPAA compliance. Committed to enhancing revenue cycle management through exceptional customer service and streamlined operations.
Overview
15
15
years of professional experience
Work History
Revenue Cycle Billing Specialist
MedAssist, a Firstsource
Louisville, KY
03.2024 - Current
- Processed patient billing and insurance claims efficiently.
- Reviewed and verified accuracy of patient accounts daily.
- Coordinated with healthcare providers to resolve billing disputes.
- Processed appeals related to denied or rejected claims in a timely manner.
- Analyzed payment trends to identify potential issues.
- Assisted in training new staff on revenue cycle procedures.
- Maintained compliance with healthcare regulations in documentation tasks.
- Researched discrepancies on unpaid invoices and reconciled them.
- Ensured all regulatory requirements were met when submitting claims for payment.
- Maintained current knowledge of insurance policies, procedures, regulations, and guidelines.
- Monitored accounts receivables daily to determine appropriate follow-up action needed.
- Identified areas where process improvements can be made within the revenue cycle.
- Assisted with the development of new processes for billing, coding, collections, and reimbursements.
- Provided training sessions on billing software applications and procedures to staff members.
- Identified and corrected payment problems involving patients or third-party payers.
- Evaluated existing workflows for efficiency and effectiveness in order to recommend changes as needed.
- Reviewed patient accounts to ensure accuracy and completeness of information.
- Audited payments from third-party payers to ensure accuracy of reimbursement amounts.
- Contacted insurance providers to check patient coverage.
- Utilized electronic health record systems for data entry.
- Collaborated with healthcare providers to ensure accurate coding and documentation.
- Conducted follow-up on unpaid or partially paid claims.
- Maintained accurate records of all transactions related to patient accounts including account adjustments, credit balance refunds.
- Reconciled payments received from insurance companies with expected amounts due.
- Ensured compliance with HIPAA regulations regarding the protection of confidential information.
- Verified patient eligibility for coverage prior to submitting claims for payment.
- Analyzed financial documents such as Explanation of Benefits statements for accuracy.
- Identified coding errors, corrected them, and resubmitted claims to payers as needed.
- Performed data entry into revenue cycle systems such as EMRs and practice management software.
- Developed strategies to reduce denials and improve overall collections performance.
- Actively participated in meetings with internal stakeholders or external vendors related to revenue cycle operations.
- Checked postings and documents for correctness, accuracy and proper coding.
- Received and recorded cash, checks and transfers.
Operations Expert
Anthem Blue Cross and Blue Shield
Wallingford, Connecticut
05.2022 - 03.2024
- Managed daily operations of a team within an assigned area or region.
- Implemented best practices for inventory management and resource allocation within teams.
- Coordinated communication between departments to ensure smooth project execution and alignment.
- Developed training materials for new team members to facilitate onboarding and skill development.
- Facilitated training sessions for staff on new systems and best practices.
- Developed standard operating procedures to improve consistency in service delivery.
- Monitored performance metrics to assess workflow effectiveness and identify improvements.
- Ensured customer satisfaction by resolving any operational issues promptly.
- Organized meetings with key personnel to discuss progress towards objectives.
- Developed detailed reports outlining progress against goals and objectives.
- Collaborated with stakeholders to ensure effective execution of plans.
- Monitored employee performance and implemented corrective actions as needed.
- Assisted in the onboarding process for new employees within the organization.
- Performed root cause analysis to troubleshoot operational issues.
- Created process documentation and trained staff on new systems.
- Evaluated current systems to determine where improvements could be made.
- Reviewed existing operations and provided recommendations for improvement.
- Analyzed data to assess performance and identify areas of potential growth.
- Mentored, coached, and trained professionals on responsibilities and procedures.
- Maintained positive working relationship with fellow staff and management.
- Utilized document management system to organize company files, keeping up-to-date and easily accessible data.
- Set specific goals for projects to measure progress and evaluate end results.
- Evaluated needs of departments and delegated tasks to optimize overall production.
Subject Matter Expert
Anthem Blue Cross and Blue Shield
Wallingford, Connecticut
01.2022 - 05.2022
- Assisted in the development of educational materials for member outreach programs.
- Resolved complex inquiries from clients regarding health plan options and services.
- Offered one-on-one support for team members and managers to drive continuous improvement.
- Provided subject matter expertise during meetings with senior leadership team members in order to discuss potential opportunities or challenges.
- Managed member/provider inquiries with a focus on providing timely resolutions while maintaining excellent customer service levels.
- Managed multiple projects simultaneously while adhering to tight deadlines.
- Maintained positive working relationship with fellow staff and management.
- Identified areas for improvement, narrowing focus for decision-makers in making necessary changes.
- Utilized document management system to organize company files, keeping up-to-date and easily accessible data.
- Identified needs of members promptly and efficiently.
Member and Provider Service Representative
Anthem Blue Cross and Blue Shield
Wallingford, Connecticut
03.2020 - 01.2022
- Listened to patients and returned calls promptly to deliver exemplary service.
- Responded to member inquiries regarding benefits and coverage options.
- Assisted members with claims processing and resolution of issues.
- Provided clear communication on policy changes and updates to members.
- Collaborated with internal teams to improve service delivery processes.
- Educated members on using online resources for account management.
- Maintained accurate records of member interactions in the system.
- Handled escalated issues with professionalism and empathy toward members.
- Cultivated relationships with teammates to assist members/providers with inquiries or resolve problems.
- Updated accounts with recent information and processed member premium payments.
- Met and exceeded productivity targets by handling every interaction with top-notch customer service.
- Resolved member and provider concerns with friendly and knowledgeable service.
- Delivered fast, friendly, and knowledgeable service for routine questions and service complaints.
- Performed needs analysis and presented options based on findings to help members make decisions.
- Kept records of member and provider interactions or transactions, thoroughly recording details of inquiries.
- Increased member satisfaction ratings by effectively answering questions, suggesting effective solutions, and resolving issues quickly.
- Enhanced productivity and customer service levels by anticipating needs and delivering outstanding support.
- Prevented key account losses by researching discrepancies and correcting problems.
- Facilitated communication between providers and support teams.
- Managed provider inquiries through various communication channels.
- Resolved provider issues by researching policies and procedures.
- Documented interactions in the provider management system effectively.
- Developed relationships with new providers by providing guidance on how to use our systems, processes, and policies.
- Participated in training sessions as needed to stay current on industry trends and best practices related to Provider Services Representative duties.
- Verified accuracy of submitted documentation prior to processing claims or services rendered.
- Responded promptly to emails sent by providers concerning billing inquiries or other related matters.
- Analyzed reports generated from the system to ensure timely submission of claims and accurate reimbursement amounts.
- Ensured compliance with HIPAA regulations while handling confidential patient information.
Shop From Home Manager
ShopRite
Waterbury, Connecticut
05.2019 - 03.2020
- Supervised staff, providing training and support for optimal performance.
- Conducted regular staff meetings to communicate updates and foster team collaboration.
- Implemented best practices for order accuracy and damage prevention.
- Managed daily scheduling of team members for optimal productivity.
- Facilitated communication between departments to streamline order fulfillment processes.
- Pulled and packed products from shelves based on customer orders.
- Conducted regular safety meetings to promote a culture of workplace safety and awareness.
- Ensured that all orders were picked accurately
- Coordinated inventory checks to maintain accurate stock levels and organization.
- Performed physical inventories on a periodic basis to verify stock levels
- Collaborated with vendors to ensure timely delivery of orders
- Developed strategies for increasing productivity while maintaining quality standards.
- Monitored the performance of workers, identified problems and provided corrective action when necessary.
- Coordinated with other departments such as receiving and customer service; to ensure timely delivery of orders.
- Analyzed data from various sources such as customer feedback surveys, sales trends. to identify areas of improvement in order fulfillment operations.
- Created reports detailing daily, weekly, monthly order picking activity for management review.
- Used handheld scanners
- Selected products and items from shelves and pallets for customer orders.
- Worked additional hours and shifts to meet tight deadlines during peak periods.
- Limited damage to products and orders by using care when choosing items.
- Tracked outgoing orders to provide delivery status to customers.
Insurance Payment Specialist
Pool Administrators
Glastonbury, Connecticut
08.2018 - 05.2019
- Processed payment transactions for various client accounts efficiently.
- Managed discrepancies in payment records and resolved issues promptly.
- Assisted clients with payment-related inquiries and provided support.
- Maintained detailed documentation of all payment activities and communications.
- Trained new staff on payment procedures and best practices.
- Implemented improvements to streamline the payment processing workflow.
- Researched discrepancies related to customer accounts and payments.
- Reviewed and analyzed contracts to resolve billing issues with vendors and carriers.
- Contacted vendors to follow up on late invoices.
- Submitted claims to insurance companies and researched and resolved denials and explanations of benefit rejections.
- Investigated customer complaints relating to unpaid invoices.
- Provided customer service support through phone, email, or other communication channels.
- Developed and maintained relationships with customers to ensure payment accuracy.
- Assisted customers with inquiries regarding payment processing.
- Maintained up-to-date knowledge of applicable laws governing payment processes.
- Collaborated with other departments within the organization to resolve any payment discrepancies.
- Identified and resolved billing issues efficiently and accurately.
- Generated, mailed and monitored invoices.
- Kept accounts receivable tracking database current with relevant client information, collection, and billing progress and program changes.
- Posted and verified entries to logs, spreadsheets or reports to update department records and accounting systems.
- Received payments and posted amounts to customer accounts.
Overnight Support Manager
Walmart
Wallingford, Connecticut
02.2012 - 02.2019
- Supervised overnight operations to ensure smooth store functionality.
- Managed inventory levels and restocked shelves as needed.
- Trained team members on safety protocols and operational procedures.
- Monitored store cleanliness and maintained a welcoming environment.
- Conducted nightly audits to verify compliance with company policies.
- Assisted in scheduling staff to optimize coverage during peak hours.
- Implemented loss prevention strategies to minimize shrinkage risks.
- Conducted regular performance reviews with team members, providing guidance on how to improve customer service delivery standards.
- Interfaced with third-party vendors when needed to resolve complex customer inquiries or incidents.
- Evaluated existing processes and identified areas for improvement.
- Identified methods to help reduce shrink and integrated strategies into regular store procedures.
- Provided coaching and mentoring opportunities for less experienced staff members.
- Investigated any reported violations of company policy or procedure by employees working the overnight shift.
- Resolved escalated issues from customers, providing clear communication regarding resolution of their concerns.
- Checked inventory levels and placed merchandise orders for restocking purposes.
- Coached and trained new employees, offering positive feedback and helpful advice when completing tasks.
- Performed necessary administrative tasks such as scheduling meetings, preparing documents.
- Assisted in developing strategies to increase efficiency within the department.
- Maintained accurate records of all activities performed during each shift.
- Helped warehouse staff by unloading trucks and using heavy equipment to properly stock merchandise.
- Resolved complex and escalated support issues.
- Provided ongoing training to maintain productivity and effectiveness of staff.
- Fostered positive and inclusive team culture for support staff.
- Led weekly team meetings to communicate business updates and review team performance.
- Completed thorough opening, closing, and shift change functions to maintain operational standards each day.
- Organized team activities to build camaraderie and foster pleasant workplace culture.
- Implemented quality control measures to uphold company standards.
Insurance Customer Service Representative
Anthem Blue Cross and Blue Shield
Wallingford, Connecticut
09.2017 - 03.2018
- Assisted customers with policy inquiries and coverage options.
- Educated clients on benefits and features of insurance plans.
- Collaborated with team members to improve customer service processes.
- Maintained detailed records of customer interactions and transactions.
- Resolved complex customer issues through effective communication skills.
- Updated client information in the company database regularly.
- Provided support during open enrollment periods for policy selection assistance.
- Assisted with customer inquiries, complaints, and requests for information regarding insurance policies.
- Advised customers on available coverage options that best fit their individual needs.
- Conducted follow-up calls to ensure satisfactory resolution of customer issues.
- Responded promptly to emails and phone calls from customers seeking assistance.
- Asked probing questions and offered solutions to resolve customer issues.
- Performed administrative duties such as filing, scanning, faxing, copying documents.
- Facilitated payment processing for premium payments and renewals.
- Actively participated in training sessions to stay up-to-date on changes in regulations related to insurance policies.
- Coordinated with insurance agents and underwriters to facilitate policy adjustments.
- Monitored insurance claims process, ensuring compliance with policy terms and conditions.
- Participated in team meetings and contributed to team goals and objectives.
- Conducted customer satisfaction surveys to identify areas for service improvement.
- Managed provider inquiries through various communication channels.
- Resolved provider issues by researching policies and procedures.
- Documented interactions in the provider management system effectively.
- Provided guidance to providers on navigating the healthcare system.
- Participated in training sessions as needed to stay current on industry trends and best practices related to Provider Services Representative duties.
- Responded promptly to emails sent by providers concerning billing inquiries or other related matters.
Associate Finance Banker
Webster Bank
Wallingford, Connecticut
12.2014 - 10.2016
- Managed customer accounts and provided personalized banking solutions.
- Conducted financial assessments to advise clients on investment opportunities.
- Provided customer service to bank clients, answering inquiries and resolving complaints.
- Maintained compliance with regulatory standards in all banking activities.
- Collaborated with team members to achieve branch sales targets consistently.
- Analyzed customer's financial information to determine the best banking products for them.
- Helped customers understand and use mobile applications and online banking.
- Helped customers open and close accounts, apply for loans and make sound financial decisions.
- Coordinated with other departments regarding customer requests or disputes resolution.
- Achieved or exceeded personal sales goals on consistent basis.
- Managed escalations with polite service, knowledgeable support and unsurpassed professionalism to satisfy needs and protect bank reputation.
- Verified customer identity using government-issued identification documents.
- Ordered checks, placed stop payment orders and conducted additional special services for customers.
- Assisted clients in setting up online banking services, enhancing accessibility and convenience.
- Utilized banking software to update client accounts and process transactions efficiently.
- Conducted risk assessments for high-value transactions to prevent fraud and financial loss.
- Stayed up-to-date on marketplace trends and researched items in detail.
Customer Service Representative
Fosdick Fulfillment
Wallingford, Connecticut
12.2012 - 10.2014
- Processed orders and managed inventory using fulfillment management systems.
- Communicated product information to enhance customer understanding and satisfaction.
- Handled returns and exchanges while ensuring compliance with company policies.
- Maintained accurate records of customer interactions and transactions daily.
- Answered customer inquiries and provided accurate information regarding products and services.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Assisted customers with product selection, ordering, billing, returns, exchanges and technical support.
- Tracked orders from start to finish to ensure timely delivery of goods or services.
- Identified opportunities for upselling additional products or services based on customer needs.
- Collected deposits or payments and arranged for billing.
- Adjusted bills and refunded money to resolve customers' service or billing complaints.
- Promoted available products and services to customers during service, account management and order calls.
- Utilized job-related software to prepare change of address records and issue service discontinuance orders.
Education
Bachelor of Science - Nutritional Science
Keene State College
Keene, NH05-2011
Skills
- Claim processing
- Insurance verification
- Billing software
- HIPAA compliance
- Revenue cycle management
- Customer relationship management
- Training and mentoring
- Insurance claim processing
Affiliations
Volunteer-Meriden Humane Society, Meriden CT 2017-Present
Timeline
Revenue Cycle Billing Specialist
MedAssist, a Firstsource
03.2024 - Current
Operations Expert
Anthem Blue Cross and Blue Shield
05.2022 - 03.2024
Subject Matter Expert
Anthem Blue Cross and Blue Shield
01.2022 - 05.2022
Member and Provider Service Representative
Anthem Blue Cross and Blue Shield
03.2020 - 01.2022
Shop From Home Manager
ShopRite
05.2019 - 03.2020
Insurance Payment Specialist
Pool Administrators
08.2018 - 05.2019
Insurance Customer Service Representative
Anthem Blue Cross and Blue Shield
09.2017 - 03.2018
Associate Finance Banker
Webster Bank
12.2014 - 10.2016
Customer Service Representative
Fosdick Fulfillment
12.2012 - 10.2014
Overnight Support Manager
Walmart
02.2012 - 02.2019
Bachelor of Science - Nutritional Science
Keene State College