LOREAMAY AMOR
Honolulu
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
16
16
years of professional experience
Work History
Patient Account Rep (Patient Services)
Hawaii Pacific Health (HPH)
12.2022 - Current
- Completes the billing process for claims generated within the department guidelines.
- Review, researches and resolves billing edits and holds reflected in edit/error report system work queues according to business office procedures for resolution.
- Follow-up on AR with third party payors and patients through the appropriate accounts receivables billing system.
- Complete the follow-up, reconciliation, and collections process within established guidelines for both debit and credit balance accounts.
- Researches and manages third party payors correspondence, remittance advice and patient correspondence with established guideline.
- Receives patient and third-party telephone calls and takes appropriate actions to address account issues and resolve outstanding receivables.
- Research the patient's concerns/issues and complies documents and information from involved parties (physicians, medical records, RAS, EOB).
- Keeps the patient informed to the status and the resolution of the concerns/issues.
- Facilitate adjustment of the account including preparation of needed forms (generating claims guarantor bills, follow-up with third party payor, preparing adjustment forms, coordinating collection agencies functions and other activities as needed to resolve the patient’s concern/issues.
- Research work list for undistributed and /or rejected payments/adjustments and resolves discrepancies.
- Informs direct supervisor of problems and concerns affecting payment process, posting, and billing.
- Follow-up with insurance payors and/or patient inquiries and communicates and cooperates with other team members to complete billing, follow-up, patient inquiry, and collection process.
- Attends and participates in departmental/divisional meetings and continuing education sessions as required.
Commercial Underwriting Support (Associate II)
First Insurance Company of Hawaii, LTD
08.2020 - 01.2022
- Review for clearance and data entry of new business submissions in systems (PMS, ImageRight, Guidewire and SalesForce) within 20 hours of receipt.
- Close out new business submissions in (PMS and SalesForce) with the close/decline reason within 2 days of receipt.
- Review and process AORs (agent of records) within 24 hours of receipt.
- Log, assemble/distribute renewal transmittals (RTs) to the agency assigned underwriters, and assist underwriters (servicing & primary) with preparation and solicitation of renewal to agency producers.
- Process renewal instructions received from agencies for (SPI, PMS, and GW) systems.
- Retrieve semi-automatic renewal listing and NCCI (The National Council on Compensation Insurance) experience mod worksheet and distribute accordingly.
Billing Department (Associate II)
First Insurance Company of Hawaii, LTD
04.2017 - 08.2020
- Balancing of worksheets, process payments and apply to applicable insured.
- Analyze/interpret various accounting journals, policies, and procedures.
- Conduct Sox testing (audit), maintain direct bill receivables, and reverse payment errors in PMS and SPI systems.
- Create correspondence letters for payments rejects such as (paid in full, short).
- Apply payments to accounts in PMS, SPI, and Guidewire systems.
- Reverse of payments for NSFs from the bank-stop payments, insufficient of funds, and create correspondence letters to insured and agency.
- Work with underwriters on what is needed for insured on certain matters (short payments, reinstatement of policies) also with agents on insured and their policies to meet what is needed.
- Work on canceled policies approved for reinstatement by underwriters making sure meeting procedural guidelines.
Administrative Specialist
Federated States of Micronesia (FSM) Department of Foreign Affair Embassy of the Federated States of Micronesia
Washington
04.2009 - 11.2011
- Worked closely with the FSM government officials and certain U.S. government officials and their respective offices relaying communication pertinent to all matters and conduct of both offices.
- Personal Secretary to the Ambassador, in that capacity, I analyzed FSM Embassy personnel concerns, and made recommendations on personnel issues.
- These were used by my superiors to determine the course of action that should be taken to address issues immediately.
- Prepared FSM staff meeting logistics focusing on personnel, management, and budgeting, and attend internal office meetings, including meeting luncheons when necessary.
- Liaison between the citizens of the FSM, the administration, and officials of the FSM Embassy.
- I oversaw citizen needs, administration concerns, and maintained a close relationship by monitoring all issues by ensuring that requests were delivered, concerns were answered, and issues were resolved.
- Monitored the integration of government personnel policies to unify with the FSM Embassy operation needs, especially Financial Management Regulations (FMR).
- I worked within the scope of our budget plans and implementations to reach fiscal year goals while successfully delivering operational functions.
- Tracked accurately leave of absences, prepared timesheets, processed payrolls manually, disbursed funds for purchase orders/requisitions in accordance with the Public Service@ System Regulations (PSSR) of the National Government of the Federated States of Micronesia.
- Managed a fiscal year budget of over $ 500,000 and was responsible for all accounting responsibilities e.g., access of bank accounts, monitoring and recording of financial transactions and balances, confirmation and wiring of funds, and prepared monthly financial reports and updates when requested.
- Performed verbal (telephonic) and written translations of Pohnpeian and English documents for defendants and hospital patients.
Education
Bachelor of Science - Criminology & Criminal Justice, Pre-Law
Chaminade University of Honolulu
12.2004
Skills
- FSM Policy & Regulatory Compliance
- HIPPA/ Legal Compliance
- Project Management
- Executive Leadership
- Team Liaison
- Financial reconciliation/Budget & Finance
- Market/ Financial Analysis
- Process improvement/ Inventory Report
- Client/ Vendor Relation
- Conflict Mediation
- Software Proficiency
Honors And Awards
- Pohnpei State Scholarship, 2000 – 2004
- Ronald McNair Scholar, Chaminade University, 2004
Timeline
Patient Account Rep (Patient Services)
Hawaii Pacific Health (HPH)
12.2022 - Current
Commercial Underwriting Support (Associate II)
First Insurance Company of Hawaii, LTD
08.2020 - 01.2022
Billing Department (Associate II)
First Insurance Company of Hawaii, LTD
04.2017 - 08.2020
Administrative Specialist
Federated States of Micronesia (FSM) Department of Foreign Affair Embassy of the Federated States of Micronesia
04.2009 - 11.2011
Bachelor of Science - Criminology & Criminal Justice, Pre-Law
Chaminade University of Honolulu