Ethel Hull
Pensacola,FL
Summary
Skilled professional with 20+ years of experience in the medical field. Background includes extensive health insurance processing, data entry, customer relations, and sales experience. Proficiencies in medical terminology, procedures and guidelines. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
13
13
years of professional experience
Work History
Recovery/Resolution/COB/Subro Representative
Optum/UnitedHealthcare/ UnitedHealth Group
04.2023 - 05.2024
- Provide expertise claims support by reviewing, researching, investigating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities
- Analyze and identify trends and provides reports as necessary
- Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance
- Solves moderately complex problems on own
- Plans, Prioritizes, organizes, and completes work to meet established objectives
- Proactively identifies solutions to non-standard requests.
Senior Claim Examiner
Change Healthcare-McKesson-MED 3000 Inc.
12.2010 - 04.2023
- Analyze and resolves medical claims by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter
- Maintains quality customer services by following customer service practices, responding to customer inquiries.
- Reduced claim resolution time by conducting thorough investigations and timely decisionmaking.
- Reviewed policy coverage details meticulously, ensuring accurate determination of benefits payable in each case.
- Researched claims and incident information to deliver solutions and resolve problems.
Education
Certificate Medical Information Coder/Biller -
PENSACOLA STATE COLLEGE
Computerized Office Systems -
SOUTHEASTERN BUSINESS COLLEGE
Skills
- Attention to Detail
- Microsoft Office
- Analytical and Critical Thinking
- Work Planning and Prioritization
- Problem Identification
- Investigative research
- Payment Processing
- Codes reviewing
Technology
Citrix- Facets, Metavance, Microsoft Office Suite including Excel, PowerPoint, Word, HRP
References
- Renita Walton-Donaldson, RN, BSN, Patient Care Manager, Women's Services, 5151 N. 9th Avenue, Pensacola, FL, 32504, 850.416.7965 or 850.748.1681
- Michelle Boykin, Enterprise Security Administrator 1, 7859 La Sierra Court, Jacksonville, FL, 32256 904.235.7322
- Angel Creer, Mortgage Loan Reviewer Audit 1809 Leigh Loop Cantonment , FL 32533 850.361.7121
Timeline
Recovery/Resolution/COB/Subro Representative
Optum/UnitedHealthcare/ UnitedHealth Group
04.2023 - 05.2024
Senior Claim Examiner
Change Healthcare-McKesson-MED 3000 Inc.
12.2010 - 04.2023
Certificate Medical Information Coder/Biller -
PENSACOLA STATE COLLEGE
Computerized Office Systems -
SOUTHEASTERN BUSINESS COLLEGE
Similar Profiles
Myrna RoneyMyrna Roney
Sr. Field Account Manager at UnitedHealth Group | UnitedHealthcareSr. Field Account Manager at UnitedHealth Group | UnitedHealthcare
Ivette WoodsIvette Woods
Medical Billing Specialist at RIVESIDE MEDICAL GROUP- UNITEDHEALTH GROUP OPTUMMedical Billing Specialist at RIVESIDE MEDICAL GROUP- UNITEDHEALTH GROUP OPTUM
Ulises Plumey GarciaUlises Plumey Garcia
Enrollment Specialist at Optum, UnitedHealth GroupEnrollment Specialist at Optum, UnitedHealth Group