ROHANNE WILLIAMS

• Preparing billing and registration worksheet

Preparing billing and registration worksheet

• Gathering and verifying current demographic information by speaking with the parents or hospital.

• Obtain correct Insurance/Medicaid information from parents.

• Contacting insurance companies to verify insurance data on accounts

• Contacting Provider to verify CPT Codes, diagnostic Codes

• Obtaining Medical records to process claims to verify admission and Discharge.

• Utilize Payer Search program to obtain correct insurance code information.

• Utilize Hospital portals such EPIC, Cerner, and Meditech

• Refer to Contract portion of Master Data Base to confirm contractual agreements with managed care companies within your assigned unit.

• Complete the registration and billing of all accounts in the OBR system.

• Release all billing and registrations according to established department guidelines.

• Submit billing worksheets to the corporate office in a timely manner in accordance to the shipment schedule.

• Company Overview: Plantation, FL
• Performs phone quality reviews; monitors inbound and/or outbound calls to analyze and evaluate customer service skills against established phone quality metrics, including but not limited, to call process measurements, accuracy of information provided, tone of employee, effective call management, and demonstrated professionalism using proprietary Call Scorecard System
• Documents quality issues and performance measures for management review; analyzes results and recurring trends; provides feedback to management concerning these findings
• Provides feedback to offer positive reinforcement and drive continuous improvement
• Demonstrates, advocates, and reinforces a positive team environment, professionalism, and the need to present a positive image of the company when interacting with customers
• Participate in and facilitate calibrations providing feedback in a concise and constructive manner
• Acted as the liaison with insurance company to verify member benefits
• Prepared data Sales team for payment after insurance verification
• Liaised with member to ensure correct data collections
• Worked closely with provider to verify correct insurance data and provide them with member benefit for claims/payments
• Prepared reports and data entry after insurance verification for claims/payment
• Plantation, FL

• Company Overview: Hollywood, FL
• Educated prospects on Emblemhealth Medicare HMO Plans
• Set appointments, seminar and telephonic enrollment
• Provided prospects with information on benefits, cost sharing, coverage and premium to encourage sale
• Looked up medicines on the formulary to verify if they were covered to encourage sale
• Made concise and detailed notations as it pertained to prospect record
• Hollywood, FL

• Company Overview: Miramar, FL
• Supervised 56 agents to ensure they were accurately educating beneficiaries on Humana Part D insurance
• Took all supervisors calls, requested by beneficiaries
• Prepared report on the day to day activities
• Interviewed new agents
• Listened to agents calls and coached them on how they should have handled a call
• Ensured that they provided accurate information etc
• Educated beneficiaries on how the Humana Part D works, including benefits, cost sharing and cost of coverage
• Made concise and detailed notations as it pertained to member record
• Looked up medicines on the formulary to verify if they were covered, the tier and copay level, and if a drug was not covered, provided and explained as to why
• Advised providers with prescription denials and errors and verified benefits
• Researched premium billing discrepancies and prescription claims processed
• Assisted pharmacies with prescription denials and errors and verified benefits
• Updated account such as billing options and changes of address or phone numbers
• Submitted mail requests for beneficiaries such as ID cards and formularies
• Answered questions pertaining to mailing sent out by the company periodically
• Miramar, FL

• Company Overview: Miami Gardens, FL
• Responsible for registration, collection of funds registration
• Responsible for data entry, record keeping, correspondence and reports
• Ordered supplies and maintained inventory of school equipment and supplies of over $2 million
• Initiated new programs to increase operational effectiveness
• Maximized consistently in providing an exceptional student experience
• Prepared end of module examinations
• Prepared registration fee for deposit in Bank account
• Miami Gardens, FL

• Company Overview: Tamarac, FL
• Effectively managed a diverse clientele and built a strong rapport with both customers and peers
• Set appointment for new and old clients
• Responsible for data entry, record keeping, correspondence, and reports to the Main Office
• Collected cash, checks, credit/debit card payment
• Prepared deposit and reports
• Tamarac, FL