Rhonda Russell
Gallipolis,OH
Summary
Accomplished Insurance Follow-Up Specialist with a proven track record at Ensemble, adept in medical billing proficiency and exceptional in conflict resolution. Demonstrated success in enhancing healthcare reimbursement through critical thinking and effective communication, ensuring HIPAA compliance and maximizing revenue with a keen understanding of insurance regulations and managed care principles.
Overview
30
30
years of professional experience
1
1
Certification
Work History
Insurance Follow-Up Specialist
Ensemble
Blue Ash, Ohio
07.2022 - Current
- Processed claims for payment according to established procedures.
- Utilized multiple payer websites to obtain detailed information about benefit eligibility and coverage levels.
- Updated databases with new and modified customer data.
- Monitored payments received from insurance companies on a daily basis.
- Conferred with customers by telephone or in person to provide information about products or services and take orders.
- Initiated appeals when necessary for denied or underpaid claims as required by contract guidelines.
- Provided top quality control and eliminated downtime to maximize revenue.
- Reviewed patient accounts and updated insurance information in the system.
- Followed up with insurance carriers regarding claim status of unpaid or rejected claims.
- Kept records of customer interactions or transactions, thoroughly recording details of inquiries.
- Completed day-to-day duties accurately and efficiently.
Insurance Follow up
Receivable Solutions Inc
Columbis, SC
03.2022 - 07.2022
- Called insurance companies to follow-up on unpaid or rejected claims.
- Updated system with order specifics and customer details, preferences, and billing information.
- Completed day-to-day duties accurately and efficiently.
- Researched patient accounts to ensure proper billing codes were used.
Insurance Follow up Specialist
Holzer Assisted Living
Gallipolis, OH
12.2019 - 03.2022
- Researched and resolved insurance discrepancies for assigned accounts.
- Ensured that all documentation was accurate and complete prior to submitting claims for payment consideration by the insurance company.
- Identified and corrected errors related to billing, coding, and reimbursement from insurance companies.
- Monitored payments received from insurance companies on a daily basis.
- Initiated appeals when necessary for denied or underpaid claims as required by contract guidelines.
- Worked collaboratively with other departments to ensure accurate follow-up processes were followed.
- Updated databases with new and modified customer data.
- Reviewed patient accounts and updated insurance information in the system.
- Updated system with order specifics and customer details, preferences, and billing information.
- Followed up with insurance carriers regarding claim status of unpaid or rejected claims.
- Processed claims for payment according to established procedures.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
Office Administrator
Hanger Clinic
Portsmouth, OH
11.2014 - 11.2018
- Completed thorough opening, closing, and shift change functions to maintain operational standards each day.
- Maintained customer confidence and protected operations by keeping information confidential.
- Ensured compliance with applicable laws regarding employment practices.
- Developed strong relationships with clients through excellent customer service skills.
- Composed correspondence such as letters, emails, memos, reports and other documents.
- Greeted visitors warmly, handled inquiries and provided general information about the company.
- Reviewed documents and obtained additional information to complete accurate paperwork and avoid delays.
- Performed clerical duties such as photocopying, faxing and scanning documents.
- Answered incoming calls in a professional manner, directed callers to appropriate personnel or department, or took messages as needed.
- Maintained supplies inventory by checking stock to determine inventory level; anticipating needed supplies; placing and expediting orders for supplies; verifying receipt of supplies.
- Resolved customer inquiries and complaints requiring management-level escalation.
- Coordinated and managed daily administrative operations of the office.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Organized and maintained filing systems, including electronic databases and records.
- Created memos, letters and other documents, fostering internal and external communication.
- Greeted visitors warmly upon arrival at the office premises.
- Replenished office supplies, placing new orders for restocking to maintain inventory.
- Prepared presentations using Microsoft Office applications such as Word, Excel, and PowerPoint.
- Recruited and trained new employees to meet job requirements.
- Updated and maintained databases with current information.
- Worked effectively in team environments to make the workplace more productive.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
Account Representative
Holzer Clinic
Gallipolis, OH
08.1995 - 04.2014
- Greeted and assisted customers to foster positive experiences.
- Conducted regular follow-up with clients to ensure satisfaction and identify additional needs.
- Maintained detailed records of all client communications.
- Resolved customer complaints in a timely manner.
- Used excellent verbal skills to engage customers in conversation and effectively determine needs and requirements.
- Identified customer needs by asking questions and advising on best solutions.
- Received and processed client payments and updated accounts.
- Set up and updated customer accounts with interactions, payments and personal information.
Education
High School Diploma -
Point Pleasant Senior High
Point Pleasant, WV06-1986
Skills
- Medical billing proficiency
- Insurance regulations
- Time management mastery
- Conflict resolution
- Electronic health records usage
- Data entry efficiency
- ICD-10 coding
- Commercial insurance
- Healthcare reimbursement acumen
- Appeals process experience
- Account resolution techniques
- Claims processing expertise
- Payment posting Know-how
- Denial management strategies
- Critical thinking capacity
- HIPAA compliance
- Effective communication
- Managed care principles
Certification
- Certified Revenue Cyle Representative
Timeline
Insurance Follow-Up Specialist
Ensemble
07.2022 - Current
Insurance Follow up
Receivable Solutions Inc
03.2022 - 07.2022
Insurance Follow up Specialist
Holzer Assisted Living
12.2019 - 03.2022
Office Administrator
Hanger Clinic
11.2014 - 11.2018
Account Representative
Holzer Clinic
08.1995 - 04.2014
High School Diploma -
Point Pleasant Senior High
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