Patricia Elie
Pulaski
Summary
Billing Follow-up Rep Lead at Advocate Aurora Health Care with proven problem-solving skills and knowledge of insurance claims processing. Successfully trained teams on new processes, improved claims processing efficiency, and enhanced customer relations. Experienced in accounting and compliance, driving quality audits and resolving complex account issues.
Overview
38
38
years of professional experience
Work History
Billing Follow-up Rep Lead
Advocate Aurora Health Care
07.2004 - Current
- Monitored Teams Caseloads
- Worked with Managed Care Operation on problem claims.
- Responded to team member questions regarding insurance benefits, provider contracts, eligibility, and claims.
- Worked with Supervisor on processes and difficult accounts.
- Worked with Insurance carriers via phone and online to get claims processed correctly.
- Monitored WQs to find ways to automate tasks.
- Research Account balancing issues.
- Worked Compliance Reports.
- Trained team on new processes.
- Worked with Cash Posting, Accounting and Application Support Analyst to identify issues with missing payments.
- Provide each team member with monthly Quality Audits.
- Assisted with training of new hires.
- Submitted No Surprise Open Negotiation forms requesting additional payment for out of network claims.
- Monitored Single Case Agreement payments negotiated by Managed Care Operations.
- Monitored all Specialty WQ assigned to the Commercial team.
- I also held the positions of Patient Account Assistant and Refund Processing Rep II prior to becoming a Lead.
Accounting Technician
Humana Insurance
06.1987 - 07.2004
- Posted Premium Payments
- Balanced General Ledger accounts
- Prepared bank deposits
- Refunded premium overpayments
- Filed reports with the states for Unclaimed Property
Education
High School Diploma -
Seymour Community High School
Seymour, WI05-1985
Skills
- Problem solving
- Customer relations
- Medical Insurance knowledge
- Accounting skills
- Vast knowledge of EPIC, Excel, Word, Sharepoint
Timeline
Billing Follow-up Rep Lead
Advocate Aurora Health Care
07.2004 - Current
Accounting Technician
Humana Insurance
06.1987 - 07.2004
High School Diploma -
Seymour Community High School
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