RENEE BLACKSHEAR

Using coded data to produce and submit claims to insurance companies,

Work directly with the insurance company, healthcare provider, Auto insurance company and patient to get a claim processed and paid,

Reviewing and appealing unpaid and denied claims

Verifying patients’ insurance coverage.

Contact business partners to obtain, track, and report information as needed for corporate and or regulatory reporting.

Maximized revenue potential by identifying and resolving under-billed accounts.

• Process all incoming and outgoing correspondence in accordance with required standards and within respective timeliness guidelines.
• Creates, updates maintain and closes out authorizations for services as assigned within process guidelines
• Ensured regulatory compliance by staying updated on industry guidelines and applying them to daily tasks and assessments.
• Contact business partners to obtain, track, and report information as needed for corporate and or regulatory reporting.

• Review physician referral orders that are submitted by the intake representative to assure accuracy of orders processed
• Enhanced customer satisfaction by identifying and resolving product defects in a timely manner.
• Use Medicare and Medicaid guidelines for patient qualifications
• Streamlined QA processes for increased efficiency, reducing time spent on repetitive tasks.
• Verify that the patient qualifies for requested item with ICD9 CODES and CPT codes
• Developed training materials for new hires, fostering a culture of continuous improvement within the QA team.

• Enhanced customer satisfaction by efficiently addressing and resolving their concerns.
• Streamlined call center operations for improved productivity and reduced wait times.
• Boosted team morale with regular feedback sessions and employee recognition programs.
• Delivered consistent high-quality service by closely monitoring team performance metrics.
• Reduced call escalations by empowering agents with the necessary tools, knowledge, and decision-making authority.
• Enhanced patient intake process by streamlining communication channels and improving documentation procedures.
• Streamlined daily operations, effectively managing a team of intake coordinators to ensure timely processing of patient information.