Rebecca Ronnfeldt
919-810-7831
Raleigh,NC
Summary
Results-oriented Customer Service Professional effective at uncovering customer needs, finding solutions and handling objections. Top performer with a consistent track record of meeting and exceeding goals. Motivated Customer Service Representative with over 15 years of retail experience in fast-paced, team-based environments. Driven and proven successful at achieving established targets and team goals. Personable and professional communicator. Skilled call center professional versed in customer support protocols. Bring extensive high-call volume experience spanning 20 years working with both medical professionals and retail consumers. Superior computer skills and telephone etiquette. Detail-oriented professional with focus on deadlines and skilled in handling medical billing without errors. Confident Medical Biller knowledgeable in data confidentiality and privacy practices when reviewing patient information.
Overview
20
20
years of professional experience
Work History
Medical Billing Specialist
Family Solutions, Inc
Wake Forest, NC
10.2019 - Current
- Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
- Posted and adjusted payments from insurance companies.
- Located errors and promptly refiled rejected claims.
- Precisely evaluated and verified benefits and eligibility.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Communicated effectively and extensively with other departments to resolve claims issues.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Prepared billing correspondence and maintained database to organize billing information.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted payments and collections on regular basis.
- Reviewed patient records, identified medical codes and created invoices for billing purposes.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Adhered to established standards to safeguard patients' health information.
- Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
- Gathered information from multiple sources to simplify billing and organize accounts.
- Managed billing calendar and scheduled claims for payments.
Personal Shopper
Shipt Inc.
11.2018 - 10.2019
- Tracked substitutions and informed customers of changes.
- Adhered to company policies and specific customer instructions.
- Picked items for customer orders with a focus on quality.
- Communicated directly with customers in a timely manner.
- Referred unresolved customer grievances to designated departments for further investigation.
- Responded to all customer inquiries thoroughly and professionally.
- Provided elevated customer experience to generate loyal clientèle.
- Received multiple positive reviews acknowledging dedication to excellent customer service.
Care Coordinator
Aerotek
07.2018 - 11.2018
- Receive incoming calls from patients and clients
- Utilized Salesforce platform to record data entry of all client and patient data
- Manage communication between my Supervisor, Program Management and Senior Staff
- Communicate and train employees on updates and changes concerning changing policies
- Take incoming calls to ensure service level agreements, workflow processes, procedures, policies and business rules are being followed
- Maintain cases for multiple office sites, ensure accurate reimbursement findings and cases are closed timely
- Assist management with special projects (Hub Reporting, Metrics, Performance Trends)
- Investigated and reported issues relating to patient care or conditions that might hinder patient well-being.
- Evaluated patient care needs, prioritized treatment, and maintained patient flow.
- Provided patient education for cost options regarding pharmaceutical drugs.
QA Analyst-Hub Services
Mckesson Corp
06.2017 - 06.2018
- Complete Call and Case Audits for 7 Hub Programs (9 different drugs)
- Manage communication between Operations, Program Management and Senior Staff
- Communicate and train employees on updates and changes concerning quality expectations
- Perform quality checks on assigned calls and cases that management request to ensure service level agreements, workflow processes, procedures, policies and business rules are being followed
- Training of New Hires for onboarding to hub programs in regard to Quality standards
- Assist management with special projects (Hub Reporting, Metrics, Performance Trends)
- Analyzed departmental documents for appropriate distribution and filing.
Patient Benefit Specialist
Biologics Inc.
10.2014 - 06.2017
- Complete benefits investigations for 7 Hub Programs (9 different drugs)
- Manage inbound and outbound calls on insurance line from patients, clients, physicians, practitioners and clinics for 7 drug manufacturer clients and their Hub Programs
- Communicate and train employees on updates and changes concerning Managed Care coverage
- Utilize technical writing skills to create and update work instructions for 7 Hub Programs
- Perform quality checks on assigned Hub Lite Programs of active patients upon management request to ensure service level agreements, workflow processes, procedures, policies and business rules are being followed
- Case Management and Escalation Support for 10-12 Patient Service Liaison Nurses for the West Region for Cosentyx
- Trained new hires on Adverse Events reporting per client request for Cosentyx (Secukinumab)
- Assist management with special projects (Special SP Project, Hub Reporting, Metrics, Performance Trends)
- Responded to customer requests via telephone and email and effectively answered questions and inquiries.
- Verified data integrity and accuracy.
Medical Billing Specialist
Uncommon Care Urgent Care
10.2013 - 10.2014
- Read and analyzed patient records in order to transcribe patient history information into shorthand to bill insurance providers
- Interacted with physicians and assistance to ensure accuracy of ICD 9 codes used for charting and billing
- Managed patient confidentiality and information security
- Selected to participate in the User Acceptance Testing of new software to debug and ensure efficiency in daily operational use
- Collected delinquent accounts by establishing payment arrangements with patients, monitoring payments and following up when payment lapse occurs
- Recognized for using professional standards, office, federal, state, local and office procedures and policies
- Created reports using medical practice billing software to identify unpaid insurance claims and patient accounts.
- Maintained self-motivation and mastered the ability to work independently to ensure on time billing processing
- Accurately posted and sent out all medical claims.
- Developed and implemented improvements to billing system to maximize efficiency, reduce delinquency and increase accuracy.
- Located errors and promptly refiled rejected claims.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls to ensure proper payments were made according to contracts.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Posted and adjusted payments from insurance companies.
- Managed various general office duties such as answering multiple telephone lines, completing insurance forms and mailing monthly invoice statements to patients.
- Consistently complied with applicable laws and regulations and ensured facility adhered to Medicare and Medicaid regulations.
- Created and maintained computerized record management systems to record and process data and generate reports.
Vice President
Dunn Medical Billing/Invex Medical Manage Solutions
01.2003 - 10.2013
- Developed and implemented office organization systems for clients
- Coded and performed trouble shooting of incorrect data on claims to obtain payment for insurance claims
- Managed the conversion of electronic practice management and billing software for multiple medical practices
- Provided consultative sessions and assisted clients in sound decision making in accordance with adapting to the changing healthcare market
- Participated in creating record keeping systems for forms and documentation needed for clients day to day operations
- Utilized strong customer and interpersonal skills to gain new business, listen to the voice of the customer and maintain lasting business relationships
- Counseled and trained medical office employees on effective change control (people, process and technology)
- Worked for Invex Medical Management Solutions after acquisition
- Attended tradeshows and client meetings, promoting the company brand and building rapport with prospects and partners.
- Identified and solved issues to drive business objectives.
- Interfaced with customers to resolve problems in a timely manner.
- Increased efficiency by analyzing data and maximizing productivity.
Education
Diploma - High School
Easley High School
Easley, SC1991
Skills
- Product knowledge
- MS Office Suite
- Detail-oriented
- Claims analysis
- People-oriented
- Claims investigation and research
- Planning and organization
- Goal-oriented
- Computer literate
- Exceptional time management skills
- Customer expectations management
- Positive and friendly
- Motivated team player
- Strong interpersonal skills
- Medical terminology knowledge
- Active listening skills
- Skilled problem solver
- Quick learner
- Call center transactions
- Database Systems
- Medicare and Medicaid Processes
- Diagnostic Codes
- Critical Thinking
- Billing Codes
- Account Management
- Work Prioritization
- Workers' Compensation Knowledge
- Verbal and Written Communication
- Electronic Health Record Software
- Billing Data Verification
Websites
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Medical Billing Specialist
Family Solutions, Inc
10.2019 - Current
Personal Shopper
Shipt Inc.
11.2018 - 10.2019
Care Coordinator
Aerotek
07.2018 - 11.2018
QA Analyst-Hub Services
Mckesson Corp
06.2017 - 06.2018
Patient Benefit Specialist
Biologics Inc.
10.2014 - 06.2017
Medical Billing Specialist
Uncommon Care Urgent Care
10.2013 - 10.2014
Vice President
Dunn Medical Billing/Invex Medical Manage Solutions
01.2003 - 10.2013
Diploma - High School
Easley High School