Summary
Overview
Work History
Education
Skills
Quote
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Patty Ballard

Jacksonville,FL

Summary

Highly personable professional with over 35 years in the Healthcare Industry and Workers Compensation Industry


Overview

35
35
years of professional experience

Work History

Medical Services Coordinator

One Call
10.2008 - Current
  • Coordinate the delivery of Custom Durable Medical Equipment within the Worker's Compensation Industry
  • Located and negotiated with National and Non National vendor network to deliver DME equipment in a timely manner
  • Created and issued Purchase Orders for payment tracking
  • Trouble shoot and understand implications of new information for both current and new new patient referrals
  • Problem Solving and making decisions on claim issues
  • Adherence to state fee schedules
  • Quoting to Insurance Adjusters for Equipment
  • Act as a liaison between the Insurance Company , Attorneys, Injured Workers and Health Care Providers
  • Trained on processing orders for TENS Units and Venaflow products
  • Coached Transportation Vendors to help insure and provide success on Transportation trips
  • Provided Vendors with scores on any issues or successful transportation services
  • Assisted vendors with wait time, rates and billing issues
  • Collected Liability Insurance Credentials for Vendors
  • Researched and submitted request to have Client Information updated to ensure proper billing for Injured workers services
  • Requested authorization from Clients for IW services as transportation and interpretation
  • Trained on 5 systems within One Call for Physical Therapy, Diagnostics, Doctor/Dental and DME equipment
  • Assisted on teams as Sedgwick, Sierra and Unbilled Report area
  • Assisted Accounts Receivable with corrections on transportation or interpretation claims to provide proper invoicing
  • Collaborated with multidisciplinary teams to develop comprehensive care plans tailored to individual patient needs.

Claims Representative

Independence Blue Cross/AmeriHealth
09.2001 - 08.2007
  • Reviewed claim files to determine eligibility and adherence to policy guidelines.
  • Communicated with clients to gather information and clarify details regarding claims.
  • Quoted PPO benefit tiers and plans
  • Consulted with Facilities and Doctor offices for claim information and updates
  • Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
  • Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
  • Investigated and resolved customer inquiries and complaints quickly.

Enrollment Specialist

Aetna
08.1995 - 09.2001
  • Updated, entered, and reviewed customer data for PPO and HMO Employers
  • Communicated effectively via telephone, email, and in person with prospective customers.
  • Enhanced customer service by promptly addressing inquiries and resolving issues in a timely manner.
  • Processed Cobra, Terminations and Open Enrollment for Large Employers
  • Trained associates on technical issues with claims

Education

All Lines Accredited Claims Adjuster

FSCJ
Jacksonville, FL
01-2025

Skills

  • HIPAA compliance
  • Organizational growth
  • Insurance verification
  • Patient care coordination
  • Documentation
  • Provider relations
  • Process improvements
  • Teamwork
  • Problem-solving abilities
  • Multitasking
  • Excellent communication
  • Critical thinking
  • Team collaboration
  • Active listening
  • Decision-making

Quote

The way to get started is to quit talking and begin doing.
Walt Disney

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Patty Ballard