Nadine Calabrese

• Reviewed EOB's and verified ICD-10 codes, processed and corrected claims in order to resubmit to insurance companies for payment via appeals and reconsiderations
• Verified patient demographics including insurance eligibility in order to send claims to correct payer for medical services
• Prepared and mailed invoices to customers, processed payments and documented account updates.
• Investigated daily variances and corrected errors to resolve discrepancies.
• Responded to customer concerns and questions on daily basis.
• Handled account payments and provided information regarding outstanding balances.
• Accurately posted payments and adjustments both electronically and manually
• Processed payments that had been received from insurance companies and Medicare

• Managed day-to-day business operations, including accounting, finance, HR, marketing and public relations.
• Applied performance data to evaluate and improve operations, target current business conditions and forecast needs.
• Discovered areas of improvement by generating quarterly operational and sales reports.
• Trained and motivated employees to perform daily business functions.
• Maintained inventory and ordered supplies and products when needed

+ Edit or add your own

• Managed day-to-day business operations.

• Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
• Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
• Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
• Attended weekly facility meetings to discuss logistical issues and obtain updated procedural and insurance-related instructions.
• Works at least 40 accounts per day to initiate authorizations and verify benefits
• Followed document protocols to safeguard confidentiality of patient records.
• Verifies insurance, benefits, coverage & eligibility, completes assigned registration financial clearance work lists activities, obtains insurance authorizations for scheduled & unscheduled Hospital services, and secures inpatient visit notification to payors.

• Interpreted contracts and communicated terms and conditions.
• Responded to ~35-50 incoming policyholder or agent midterm
  requests for making policy payments or making changes to their policy
  via phone per day, and also processed non-phone (aka paper) requests
  between calls.
• Determined true need of requests through consultation and
  problem solving, and offered customer-focused, low effort solutions while continuously demonstrating Hartford Behaviors (accountability, empowered, customer centric, self-sufficient)
• Worked cross-functionally with various members of other teams to complete requests.(i.e. CARE, Underwriting, Billing Tier 2, etc.)
• Attended daily Huddle Meetings as scheduled by CSR Manager or
  management staff to discuss updated/changes in policies and
  procedures, customer feedback issues and resolutions, and analyze root
  cause problem solving discussions
• Promoted superior experience by addressing customer concerns, demonstrating empathy and resolving problems swiftly.

• Assisted patients in filling out check-in and payment paperwork.
• Took copayments and compiled daily financial records.
• Provided front office registration duties such as answering phones, greeting, verifying benefits, HIPAA consent forms, patient demographics and payment receipt.
• Organized patient records and database to facilitate information storage and retrieval.
• Scanned and entered patient information/medical reports in patient
  files through EPower.
• Answered telephone in polite manner and communicates efficiently, and when necessary, transfers calls or information to appropriate staff.

• Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
• Contributed to reduction of accounts receivables by adhering to predetermined policies and procedures to recover amounts due from patients.
• Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
• Verified necessary physician referrals and insurance authorizations,
  as well as making sure that ICD9 and CPT codes are correct
• Received patient deductibles and co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
• Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.

• Performed receptionist work related to answering phones, scheduling
  patient appointments, verified insurance eligibility, benefits, and
  referral authorizations, and collected co-pays
• Spent time in medical records department filing paperwork and
  requesting charts for patients and doctors
• Handled patient payments and applied them to correct accounts