MARY REED
Summary
To secure a Remote job within Insurance follow up, Patient Representative, Customer
service or Clerical in general That furnish the equipment needed for the job
Overview
26
26
years of professional experience
Work History
Mac's Solutions
02.2015 - Current
- Taking customer calls, making calls to customers
- Keeping necessary records for the business
- This was part-time and PRN.
Receptionist/Customer Service Rep
AppleOne Employment Agency
Brentwood, TN
01.2013 - 01.2015
- I worked temporary while I was married
- I worked doing Receptionist and administrative work, such as checking home loans for completion, answering telephones, entering information into the computer and did basic office work
Customer Service Representative
Office Team Employment Agency
09.2014 - 10.2014
- I only worked one month for Office Team but worked consistent for AppleOne
- Worked at Tennessee Health Connection taking calls for insurance regarding TennCare,
- Medicaid, Cover Tenn
- Etc., provided benefit information also how and where to apply
Patient Acct. Rep
Pride staff Employment Agency
Nashville, TN
03.2012 - 07.2012
- Worked patient accounts and made adjustments, re-billed claims, filed appeals and medical collections
- Precisely completed appropriate Appeal's, documentation and system entry
- Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical claims and patient accounts
- Maintained updated knowledge of coding and billing requirements
- Verified patients' eligibility and claims status with insurance agencies
- Diligently filed and followed up on third party claims
- Determined prior authorization for patient procedures
- Researched questions and concerns from providers and provided detailed responses
- Compiled and tracked outstanding balances owed to medical facilities
- Prepared billing correspondence and maintained database to organize billing information
Medical Records Clerk
Randstad Employment Agency
Nashville, TN
11.2011 - 03.2012
- Sorted, filed and copied medical records and answered the telephone and filed medical records
- Answered telephone and called on outstanding accounts
Team Lead/Receptionist
American Esoteric Labs
Nashville, TN
11.2010 - 09.2011
- Billed all lab charges for Nursing Home's, Physician's and Clinic's
- Collected on all facilities billed
- Handled all correspondence and issues from the facilities and insurance companies
- Answered all calls concerning billing and collections
- Made corrections in DDE for Medicare claims and re-bill
- Worked all Medicare, Medicaid and commercial insurance appeals
- Handled all prior-authorizations when needed
Interviewer II
Tennessee Department of Labor
Nashville, TN
12.2008 - 10.2010
- Interviewed unemployed claimants over the telephone to obtain necessary information to determine eligibility for unemployment checks, according to the laws and guidelines of
- Tennessee
- Explained and interpreted unemployment program guidelines and regulations to claimants
- Entered all information needed on statements for Adjudicator's and completed all documents necessary for their decision making process
- Contacted employers to verify claimant work history, discharge or quit information Maintained daily claimant information file for any required follow up
- Traveled to other cities in Tennessee and took TRA federal claims
Customer Service Representative
Cigna Government Services
Nashville, TN
05.2008 - 07.2008
- Department, informing Durable Medical Equipment
- Providers of how to bill their Medicare claims correctly
- Answered questions about Medicare billing guidelines and regulations
- Documented questions and answers on Excel spreadsheet
Administrative Paralegal
Platinum Realty
Nashville, TN
06.2006 - 05.2008
- Prepared documents needed in property closing appointments
- Prepared files for each client or Realtor
- Processed all office accounting
- Talked to buyers and sellers about property listings
Administrative Paralegal
Tennessee Department, Human Services
Nashville, TN
09.2005 - 06.2006
- Audited TennCare accounts for accuracy or fraudulent information
- Prepared legal documents for TennCare hearings
- Corresponded with claimants and Attorneys on TennCare
- Contracts and hearings
Reimbursement Specialist
DaVita Healthcare
Brentwood, TN
02.2000 - 07.2005
- Collected outstanding insurance balances on patient accounts and insurance Audited and billed claims for payment corresponded with insurance companies about contract payment errors
- Maintained running balances on insurance payments and payment retractions
- Maintained Excel spreadsheet on all accounting transactions and insurance follow up
- Verified insurance for coverage, deductible, out-of-pocket, in or out of network
- Corrected patient accounts with billing and or payment errors
Education
Associate of Science - Business Administration
s Jr. College
Paralegal Certification: Law -
Southeastern College
Affiliations
Excellent, written and verbal customer service skills advanced computer skills.
Thorough knowledge of SNV, HHA, OT, PT, and ST visits and how they are billed
Accurate accounting skills with ten-key by touch
Over ten years of medical terminology ICD-10 and CPT codes
Billing and collection procedures expert with thorough knowledge of Appeal's
Patient chart auditing ability
Thorough knowledge of DRG, UB04 and HCPC coding guidelines
Thorough knowledge of commercial and private insurance carriers and COB
Thorough knowledge of legal terminology, Discovery, Lexus Nexus, West Law etc.
Call Center Certificate
Timeline
Mac's Solutions
02.2015 - Current
Customer Service Representative
Office Team Employment Agency
09.2014 - 10.2014
Receptionist/Customer Service Rep
AppleOne Employment Agency
01.2013 - 01.2015
Patient Acct. Rep
Pride staff Employment Agency
03.2012 - 07.2012
Medical Records Clerk
Randstad Employment Agency
11.2011 - 03.2012
Team Lead/Receptionist
American Esoteric Labs
11.2010 - 09.2011
Interviewer II
Tennessee Department of Labor
12.2008 - 10.2010
Customer Service Representative
Cigna Government Services
05.2008 - 07.2008
Administrative Paralegal
Platinum Realty
06.2006 - 05.2008
Administrative Paralegal
Tennessee Department, Human Services
09.2005 - 06.2006
Reimbursement Specialist
DaVita Healthcare
02.2000 - 07.2005
Paralegal Certification: Law -
Southeastern College
Associate of Science - Business Administration
s Jr. College