Pauline Jones

• Monitored outstanding invoices and performed collections duties.
• Identified, researched, and resolved billing variances to maintain system accuracy and currency.
• Maximized revenue potential by identifying and resolving under-billed accounts.
• Strengthened client relationships through effective communication regarding billing issues and concerns.

Handle 20-85 calls per day to address customer inquires and concerns.

Worked with various customers as well as physicians and medical staff to understand the needs and provide excellent customer service.

Resolves a variety of difficult issues. De-escalate irate calls and provide efficient, effective quality service to members, physicians, vendors, employer groups and managed care organization.

• Guided office staff on how to effectively complete prior authorization forms and appeals documentation to achieve positive results.
• Prevented delays and claim denials by correcting information prior to submission.
• Improved departmental accuracy through meticulous attention to detail while reviewing claims submissions.
• Advanced internal communication channels by sharing best practices among colleagues, fostering an environment of continuous learning and improvement.