Summary
Overview
Work History
Education
Skills
Languages
References
Timeline
Generic

Gwendolyn Carelli

Auburn,MA

Summary

Accomplished Senior Medical Billing Specialist at Receivable Outsourcing LLC, adept at claims processing and dispute resolution. Successfully reduced outstanding accounts through effective communication and problem-solving skills. Expert in insurance verification and HIPAA compliance, ensuring accuracy and confidentiality while enhancing patient satisfaction and revenue generation.

Overview

39
39
years of professional experience

Work History

Senior Medical Billing Specialist

Receivable Outsourcing LLC
Worcester, MA
08.2009 - Current
  • Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
  • Responded to inquiries from providers regarding claim status, reimbursement rates.
  • Checked claims coding for accuracy with ICD-10 standards.
  • Collected, posted and managed patient account payments.
  • Utilized various security techniques to maintain confidentiality of client data.
  • Provided training and support to staff members on medical billing processes.
  • Resolved discrepancies between charges billed and payments received from insurance companies or other third-party payers.
  • Submitted appeals using provider portals and phone communication.
  • Performed insurance verification, pre-certification and pre-authorization.
  • Input details into accounts and tracked payments.
  • Applied HIPAA privacy and security regulations while handling patient information.
  • Answered customer questions to maintain high satisfaction levels.
  • Reviewed claims rejections and denials to determine appropriate action needed for resolution.
  • Monitored customer account details for non-payments, delayed payments, and other irregularities.
  • Reviewed payment plans with patients according to established protocols.
  • Monitored past due accounts and pursued collections on outstanding invoices.
  • Processed appeals on denied claims as necessary.
  • Reviewed account information to confirm patient and insurance information is accurate and complete.
  • Updated patient accounts as needed based on changes in insurance coverage or financial responsibility.
  • Participated in workshops, seminars, and training classes to gain stronger education in industry updates and federal regulations.
  • Submitted claims to insurance companies.

Senior Real Estate Tax Rep

First American Real Estate Tax Service
Worcester, MA
02.1999 - 01.2009
  • Analyzed financial information of clients to determine appropriate filing status.
  • Responded promptly to inquiries from customers regarding their individual tax situations.
  • Applied mathematical skills to calculate totals, check figures, and correct problems with physical and digital files.
  • Cross-trained employees, enabling completion of priority tasks during personnel absences.
  • Sifted through large quantities of data and accurately transferred necessary information to electronic spreadsheets.
  • Prepared source data by compiling necessary documents, files and information at start of each new project.

Pre-Mastering Technicion

Omni Muti-Media
Millbury , MA
01.1995 - 01.1999
  • Conducted system analysis and testing to identify and resolve technical issues or inefficiencies.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Collaborated closely with team members to achieve project objectives and meet deadlines.
  • Managed inventory and supplies to ensure materials were available when needed.
  • Operated a variety of machinery and tools safely and efficiently.
  • Prioritized and organized tasks to efficiently accomplish service goals.
  • Managed time effectively to ensure tasks were completed on schedule and deadlines were met.

Microfiche Techinicion/ Commerical Loan Department

Evergreen Bank
Glens Falls , NY
07.1989 - 12.1995
  • Completed routine maintenance and repair.
  • Updated and maintained databases with current information.
  • Provided support and guidance to colleagues to maintain a collaborative work environment.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Provided excellent service and attention to customers when face-to-face or through phone conversations.
  • Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
  • Completed day-to-day duties accurately and efficiently.
  • Utilized various software and tools to streamline processes and optimize performance.
  • Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.

Bank Teller

Portsmouth savings Bank
Greenland , NH
08.1986 - 06.1989
  • Researched customer inquires regarding their accounts using internal banking systems.
  • Provided assistance to other tellers during peak business hours as needed.
  • Processed customer deposits and withdrawals accurately, balancing cash drawer daily.
  • Identified suspicious activity on account holders' accounts and reported any discrepancies to the supervisor immediately.
  • Verified customer signatures on documents and ensured accuracy of all paperwork before submitting for approval.
  • Resolved customer disputes promptly in accordance with bank policies and procedures.
  • Reconciled daily sales sheets with actual physical money received from customers or deposited into ATM machines.
  • Processed deposits, withdrawals, transfers, loan payments and other transactions accurately and efficiently.
  • Followed strict compliance guidelines when completing financial transactions for customers.
  • Maintained confidentiality of bank records, transactions and customer information.
  • Handled large sums of money with accuracy while maintaining appropriate levels of security.
  • Balanced teller drawers regularly throughout the day according to established procedures.
  • Performed cash handling duties including counting currency, coins and checks.
  • Developed strong relationships with customers to ensure repeat business.
  • Cashed customer checks, verified identification and checked account balances in accordance with bank policy.
  • Provided exceptional customer service to customers by answering inquiries, resolving complaints and processing transactions in a timely manner.
  • Served large number of customers during high volume shifts and remained composed and professional in stressful situations.
  • Counted drawers and reconciled remaining cash to accost for deposits and dispersals.
  • Offered every customer exceptional service levels by remaining friendly and professional during every transaction.
  • Counted currency, coins and checks received to prepare for deposit or shipment to branch banks or Federal Reserve Bank.

Education

Some College (No Degree) - Banking And Finance

Adriondack Community College
Queensbury, NY

Skills

  • Claims processing
  • Insurance verification
  • Data entry
  • Patient billing
  • Customer service
  • Payment tracking
  • Problem solving
  • Communication skills
  • Dispute resolution
  • Billing systems
  • Problem-solving
  • Teamwork
  • Customer contact
  • Collection calls
  • Process payments
  • HIPAA compliance certification
  • Billing data verification

Languages

English
Full Professional

References

References available upon request.

Timeline

Senior Medical Billing Specialist

Receivable Outsourcing LLC
08.2009 - Current

Senior Real Estate Tax Rep

First American Real Estate Tax Service
02.1999 - 01.2009

Pre-Mastering Technicion

Omni Muti-Media
01.1995 - 01.1999

Microfiche Techinicion/ Commerical Loan Department

Evergreen Bank
07.1989 - 12.1995

Bank Teller

Portsmouth savings Bank
08.1986 - 06.1989

Some College (No Degree) - Banking And Finance

Adriondack Community College

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