Julie Waldo
Park City,MT
Summary
Experienced Senior Health Insurance Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 10 years of experience and willingness to take on any challenge. Experienced leader with strong background in guiding teams, managing complex projects, and achieving strategic objectives. Excels in developing efficient processes, ensuring high standards, and aligning efforts with organizational goals. Known for collaborative approach and commitment to excellence.
Overview
36
36
years of professional experience
1
1
Certification
Work History
Senior Insurance Specialist
MEDUIT
07.2022 - Current
- Verify new insurance coverage for patients through various websites, software or phone call.
- Review insurance discrepancies on accounts.
- Work with team 4 supervisors on any insurance issues that arise for the patient service representatives or patient's.
- Work on various reports and create new spreadsheets requested by the client,
- Meet with the client if requested,. Correspond through emails to the client's customer service department if issues arise that need the client to advise how to resolve.
- Review team members work for quality assurance purposes.
- Train new employees for the team.
- Enhanced customer satisfaction by addressing insurance-related inquiries and resolving issues promptly.
- Processed eligibility and benefits verification and authorization requests.
- Followed up on denials, late payments, extensions and other special circumstances.
- Tracked pending authorizations to resolve discrepancies and avoid revenue loss.
- Resolved discrepancies in insurance payments by collaborating with carriers.
- Contributed to team performance by sharing industry knowledge and assisting colleagues in complex cases.
- Trained new hires on company policies and procedures, ensuring a seamless transition into the Insurance Specialist role.
- Maintained confidentiality of patient finances, records, and health statuses.
- Responded to customer calls swiftly to resolve issues and answer questions.
- Monitored changes in insurance industry to stay compliant with relevant laws and regulations.
- Prepared and reviewed insurance applications to verify compliance with regulations.
- Build relationships with clients using active listening and issue resolution to provide excellent service.
- Analyzed customer needs to provide customized insurance solutions.
- Monitored customer feedback and identified areas of improvement.
Health Insurance Specialist
MEDUIT
07.2022 - Current
- Verify new insurance coverage for patients through various websites, software or phone calls
- Review insurance discrepancies on accounts
- Work with team 4 supervisors on any insurance issues that arise for the patient service representatives
- Work various reports and create new spreadsheets requested by the client
- Meet with the client
- Correspond with the client's customer service department if issues arise that client input is needed to resolve
- Review team members work for quality assurance purposes
- Train new hires
- Develop comprehensive training materials, improving team performance and increasing overall productivity.
- Monitored industry trends closely to adapt strategies accordingly and maintain a competitive edge in the marketplace.
- Played an instrumental role in driving company growth through strategic planning efforts as well as execution of key initiatives.
- Designed tailored insurance solutions for clients based on their unique needs and risk profiles.
- Optimized claim processing times by implementing efficient workflows and leveraging automation technologies.
- Enhanced customer satisfaction by efficiently resolving complex insurance claims and disputes.
- Mentored junior staff members, fostering a positive work environment that promoted professional growth.
- Cultivated relationships with clients to identify and meet insurance needs and establish trust and rapport.
SENIOR PATIENT SERVICE REPRESENTATIVE
MEDUIT
11.2017 - Current
- Daily tasks included the collection of payments due on accounts through incoming approximately 65 inbound and outbound calls concerning delinquent accounts
- Answering questions for patients about the insurance process and charges on accounts
- Processing automatic and live payments daily
- Returning supervisor calls as needed
- Working on various reports and projects
- Participating in training of new employees and answering questions from employees
- Working daily in work queues pertaining to payment plans, patient complaints, issues with their accounts, health insurance verification, processing and billing
- Working in various systems for our team
- Multi-task in a fast-paced environment including working overtime and weekends at times
- Work as a part of the supervisor team for our group.
- Maintained strict confidentiality of patient information in compliance with HIPAA regulations.
- Managed high call volume, prioritizing urgent requests while maintaining professionalism and accuracy in documentation.
- Streamlined appointment scheduling process for increased efficiency and reduced wait times.
- Supported clinical team by managing inventory levels of supplies, proactively ordering replacements when needed.
Patient Service Representative
MEDUIT
05.2014 - Current
- Participated in ongoing training programs related to HIPAA compliance, maintaining up-to-date knowledge on regulatory requirements.
- Verified insurance eligibility and coverage for patients.
- Handled sensitive patient concerns with professionalism and empathy, fostering an atmosphere of trust within the clinic.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Provided exceptional customer service to patients, answering questions and addressing concerns.
- Managed patient registration process, confirming data accuracy and completeness.
- Assisted with insurance verification tasks, ensuring accurate billing and timely reimbursement for services rendered.
- Took copayments and compiled daily financial records.
- Balanced deposits and credit card payments each day.
- Built and maintained positive working relationships with patients and staff.
- Actively participated in team meetings focused on improving workflows and enhancing overall practice performance.
- Handled complex insurance pre-authorization processes accurately, enabling timely delivery of necessary medical services.
- Provided compassionate support for patients facing financial challenges, assisting them in navigating available resources and payment options.
- Supported new Patient Service Representatives'' orientation process by sharing expertise on office procedures.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Provided excellent customer service to patients and medical staff.
- Verified patient insurance eligibility and entered patient information into system.
- Followed document protocols to safeguard confidentiality of patient records.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Trained new staff on filing, phone etiquette and other office duties.
- Engaged with patients to provide critical information.
- Resolved customer complaints using established follow-up procedures.
OWNER/OPERATOR
Julie's Daycare
07.1988 - 10.2013
- Responsible for all aspects of the business
- Researched State of Montana Child Care regulations and established a business plan in accordance with the same
- This required accurate recordkeeping of daily operations and year-end records for tax purposes
- Obtained regulations for the State of Montana Child and Adult Food Program
- These required the establishment of a monthly menu as well as procurement and preparation of the meals for staff and clients
- Oversee the safety and care of children from 0 to 12 years of age
- This included children with disabilities and terminal illness
- Use Quicken and Quick books to ensure accuracy of all financial transactions and records.
Education
Bachelor of Science - BUSINESS
CAPPELA UNIVERSITY
Minneapolis, MN09.2013
Associate of Applied Science - HEALTH INFORMATION MANAGEMENT
WILLISTON STATE COLLEGE
Williston, ND12.2007
High School Diploma -
GARFIELD COUNTY HIGH SCHOOL
Jordan, MT05.1984
Skills
- Supervisory role and the skills needed to work as a lead
- Computer proficiency with Windows 10, Google Docs, Epic, Star, Microsoft Office, document scanning, emailing and filing as well as competency in computer and internet usage
- Office management
- Maintaining professional composure while under stress
- Efficient multi-tasking
- Establishing and maintaining positive client/ customer relations
- Reporting skills
- Insurance law knowledge
- Claims Management and reporting systems
- Client Account Management
- Regulatory Compliance
- Operations Management
- Critical Thinking
- Insurance Coverage Verification
- Customer Complaint Resolution
- Data Entry
- Billing Inquiries and Procedures
- Insurance Claim Regulations
- Relationship Building
- HIPAA Compliance
- New Agent Training
- Administrative Functions
- Regulatory Requirements
- Quality Assurance Requirements
Certification
Certified Revenue Cycle Specialist
References
- Danielle Warburton, 406-390-6429
- Lisa Hammond, 406-861-5285
- Vanja Leka, 515-441-0017
Timeline
Senior Insurance Specialist
MEDUIT
07.2022 - Current
Health Insurance Specialist
MEDUIT
07.2022 - Current
SENIOR PATIENT SERVICE REPRESENTATIVE
MEDUIT
11.2017 - Current
Patient Service Representative
MEDUIT
05.2014 - Current
OWNER/OPERATOR
Julie's Daycare
07.1988 - 10.2013
Bachelor of Science - BUSINESS
CAPPELA UNIVERSITY
Associate of Applied Science - HEALTH INFORMATION MANAGEMENT
WILLISTON STATE COLLEGE
High School Diploma -
GARFIELD COUNTY HIGH SCHOOL