Taleezia Wallace
Columbus,OH
Summary
Organized individuals multitask and liaise between patients, physicians and insurance companies. An astute Financial Counselor offering extensive healthcare insurance knowledge and proficiency in Medicaid coverage.
Overview
10
10
years of professional experience
Work History
Financial Counselor
Nationwide Children’s Hospital
10.2022 - Current
- Assist Patients with obtaining Medicaid coverage
- Screens for eligibility
- Liaison between families and county services
- Creates rapports with families to provide them with resources
- Sends emails, creates templates, conduct phone interviews
Customer Service Representative
State Auto Insurance
12.2021 - 04.2022
- Utilize various State Auto and third-party systems to respond to incoming telephone customer inquiries and resolve any related issues
- Provide follow up resolution to customers via outgoing calls and correspondence templates
- Process policy corrections according to company guidelines
- Authorize write-offs of various fees and charges according to company guidelines and procedures
- Meet Department Service Level Agreements.
Customer Service Representative
State Of Ohio
03.2020 - 12.2021
- Knowledge of disability insurance claims policies & procedures
- Ability to recognize accurate/completed documentation
- Reviewing claims to determine allowance using code manual ICD/CPT & taking necessary action on self-insured claims or referring documentation to member of claims team, reconstructing lost claim files
- Monitoring & managing caseload of self- insured medical & disability claims to ensure compliance with worker compensation law & researching hearing decisions on claims & updating claims folder on computer to reflect decision
- Help medical claims team or act as primary claims resource in specialized unit by ensuring all documents are complete, accurate & in compliance with bureau procedures
- Referring documents to members of claims team for resolution of medical issues, assigning claim numbers, updating claim information, & monitoring & managing caseload of self-insured medical & disability claims to ensure compliance with workers' compensation law
- Function as a primary claims resource within compline by providing on-line telephone assistance to injured workers, employers & medical providers.
- Handled customer inquiries and suggestions courteously and professionally.
- Answered constant flow of customer calls with minimal wait times.
HR Generalist
Nationwide Children’s Hospital
03.2017 - 03.2020
- Provide support to the HR Strategic Partner function by actively participating as a working contributor on addressing inquiries and/or requests fielded from management and staff
- Serves as a point of escalation for employees to resolve issues or direct to the correct channels
- Assist with the identification of organizational needs to improve employee practices and HR compliance across the organization
- Generates reports and helps advise on NCH policies and practices
- Manages the internal grievance process
- Conducts confidential investigations related to possible employee relations, EEO, security, safety, and other policy violations
- Conducts employee exit interviews
- Delivers assigned Employee Relations Training
- Manages the mandatory employment law posting for all NCH facilities
- Assists with unemployment claims, responding to, management of, and attending hearings
- Handles employment-related inquiries from applicants, employees, and supervisors, referring complex and/or sensitive matters to the appropriate staff
- Maintains compliance with federal, state, and local employment laws and regulations.
Patient Access Representative
10.2015 - 03.2017
- Interviews and registers patients in registration areas that report through Patient Access
- Obtains accurate demographic, insurance, and physician information on registrations
- Process follow up appointments for various clinics (Adolescent, Healthy Weight, Primary Care)
- Screen’s customer data to ensure patient is eligible for insurance indicated
- Communicate with the diverse community that NCH serves to ensure quality customer service
- Screen EMR to ensure insurance pre-certification and physician referral requirements are met
- Display optimistic attitude to discuss decisions or policies in a positive, problem-solving manner
- Date entry and collecting information
- Explaining policies and procedures
- Greetings
- Billing and payment information.
Education
Associates Degree - Human Resources, Marketing
Columbus State Community College
Columbus05.2025
HS Diploma -
Eastmoor Academy High School
Columbus, OH06.2012
Skills
- Communications Expertise
- Verifying Eligibility
- Making Insurance Decisions
- Client Interactions
- Financial Efficiency
- HIPAA and Confidentiality Compliance
- Client Counseling
- Excellent Communication
- Good Telephone Etiquette
Timeline
Financial Counselor
Nationwide Children’s Hospital
10.2022 - Current
Customer Service Representative
State Auto Insurance
12.2021 - 04.2022
Customer Service Representative
State Of Ohio
03.2020 - 12.2021
HR Generalist
Nationwide Children’s Hospital
03.2017 - 03.2020
Patient Access Representative
10.2015 - 03.2017
Associates Degree - Human Resources, Marketing
Columbus State Community College
HS Diploma -
Eastmoor Academy High School