TERESA EDWARDS
Rochester,NY
Summary
Quality-focused Data Entry Clerk experienced in data processing, coding and transcription. Skilled at entering data quickly with strong attention to detail and accuracy. Team player with outstanding communication skills and flexibility in working with others. Dedicated Customer Service Specialist providing skills to prioritize and multi-task in fast-paced working environment. Successfully works as part of team to reach personal and business goals. Known for successfully handling escalated customer support issues.
Overview
13
13
years of professional experience
Work History
Data Entry Specialist
Paychex Insurance Agency
Rochester, NY
02.2020 - Current
- Identified, corrected and reported data entry errors.
- Completed accurate and efficient data entry and database updates to support business operations.
- Input client information into spreadsheets and company database to provide leaders with quick access to essential client data.
- Identified and corrected data entry errors to prevent duplication across systems.
- Reviewed and updated account information in company computer system.
- Identified errors in data entry and related issues by mentioning to supervisors for resolution.
- Adhered to strict data confidentiality policies to prevent information leakage.
- Communicated with coworkers regarding deadlines and project milestones.
- Proofread and edited documents to correct errors.
Claims Specialist
Alera Group
Rochester, NY
04.2020 - 02.2022
- Researched and reviewed information to determine validity of insurance claims and contacted companies and customers about decisions.
- Documented specific claims by completing and recording forms, reports and logs.
- Planned and conducted investigations of claims to confirm coverage and compensability.
- Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
- Communicated with other departments to establish action plans and manage open claims to closure.
- Determined covered insurance losses by studying provisions of policies or certificates.
Claims Analyst I
Benefit Resources
Rochester, NY
01.2020 - 03.2020
- Inputting patient claims from the FSA or HSA account
- Mailing Denials
- Verifying entry on claims are accurate and correct
- Heavy Data Entry
- Inbound calls concerning payments being released
- Inbound intake forms from employers to and employee to accounts
Manage Care Specialist
Strong Memorial Hospital
Rochester, NY
02.2019 - 12.2019
- VERIFYING PATIENTS INSURANCE THROUGH VARIES INSURANCE WEBSITE INCLUDING: - EXCELLUS - MVP - OPIUM - WNH - ONE SOURCE - CONNEX - EPACES - FIDELIS - MANAGE CARE SPECIALIST - ADVANTAGE PLAN SPECIALIST - TAKING INCOMING CALLS FROM PATIENTS TO UPDATE PERSONAL DEMOGRAPHIC INFORMATION IN EPIC
Front Desk Medical Receptionist/billing Assistant
ALEXANDER MEDICAL GROUP
08.2018 - 01.2019
- Managing patient phone calls and scheduling patient office visits and procedures
- Entering patient information into electronic medical record
- Contacting insurance companies to obtain prior authorizations as needed
- Manage patient recalls
- Cross-train to room & check out patients as needed
- Other duties as assigned
- Responsible for registering patients and coordinating with back-office personnel for timely turnaround
- Responds to patient questions and concerns, both on the telephone and in person and is responsible for all paperwork associated with patient registration
- Medent Experience - Posting of EFT's - Ability to read a ledger - Knowledge in Research / Adjustments / Charge Entry - General Posting of Paper checks and personal payments - Insurance Knowledge and Insurance Website knowledge - Understanding of Remittances / Denials
- Financial Counsel
STRONG MEMORIAL HOSPITAL
10.2017 - 08.2018
- Incoming Patient Inquiries
- Receive incoming calls from both internal and external customer regarding billing issues, in a timely and customer friendly manner
- Receive incoming calls regarding outstanding balances as a result of statements sent
- Perform review and research procedures on billing issues on patient accounts
- Verify and update demographic and insurance information
- Initiate insurance billing either electronically or via the use of the Electronic Work file transfer process within the Flowcast system for accounts classified as Self-Pay in error
- Identify and verify coverage under the government health insurance programs
- Create Budget payment plans for those callers in need
- Advise callers about insurance and payment options in order to secure revenue for Strong Health and the Strong enterprise in general
- Outgoing Patient Calls
- Initiate outgoing calls to customers regarding outstanding balances, in a timely and customer friendly manner
- Receive incoming calls regarding outstanding balances as a result of collection letters sent
- Perform review and research procedures on billing issues on patient accounts
- Verify and update demographic and insurance information
- Initiate insurance billing either electronically or via the use of the Electronic Work file transfer process within the Flowcast system for accounts classified as Self-Pay in error
- Identify and verify coverage under the government health insurance programs
- Create Budget payment plans for those callers in need
- Advise callers about insurance and payment options in order to secure revenue for Strong Health and the Strong enterprise in general
- Work File Maintenance
- Pre-Verification on Surgical booking Sheets to verify coverage is active and effective, if deductible and OOP have been met
- Create and follow ticklers on research issues
- Track and trend billing and provider issues
- Using best judgment under set procedures, alert management team to issues not completed within specified timeframes.
Office Lead Registrar/Biller
WORKFIT MEDICAL
Rochester, NY
09.2015 - 10.2017
- Use computers for various applications, such as database management or word processing
- Answer telephones and give information to callers, take messages, or transfer calls to appropriate individuals
- Operate office equipment, such as fax machines, copiers, or phone systems and arrange for repairs when equipment malfunctions
- Set up and manage paper or electronic filing systems, recording information, updating paperwork, or maintaining documents, such as attendance records, correspondence, or other material
- Process, prepare, and submit business or government forms, such as submitting applications for coverage to insurance carriers
- Process and record new insurance policies and claims
- Review and verify data, such as age, name, address, and principal sum and value of property on insurance applications and policies
- Modify, update, and process existing policies and claims to reflect any change in beneficiary, amount of coverage, or type of insurance.
Patient Account Representative
Kelly Services
Rochester, NY
10.2010 - 09.2015
- Secured housing, medical care and employment for clients by working with The Department of Social Services
- Interviewed and evaluated clients, including conducting safety and Risk assessments
- Reported to Federal Probation/Parole regarding patients' history and Present behavior
- Referred clients to social services agencies
- Assessed clients for abuse and neglect and compiled documentation for court reports
- Daily reports in Ares system, updating and inputting patients reports
- Taught patients how to apply for insurance and prescription programs
- Referred patients to psychiatric and medical examinations, as well as to family assessment planning teams
- Successfully implemented new technologies and process automations
- To encourage continuous improvement
- Posted receipts to appropriate general ledger accounts
- Monitored payments due from clients and promptly contacted clients with past due payments
- Reconciled discrepancies between accounts receivable general ledger
- Account and accounts receivable trial balance account
- Researched and resolved accounts payable discrepancies
- Filed and addressed employee complaints in accordance with company policies and government regulations
- Insurance Verification.
Education
Skills
- Associate
- Microsoft Office (Word, Excel, Problem solver
- Strong Dedicated team player
- Team liaison
- Strong verbal communication
- Epic
- Self-motivated Team leadership
- Citrix
- Conflict resolution Customer and Personal Services
- Pulse Check
- Data auditing
- Data input
- Error verification
- Excel expertise
- Verifying data accuracy
- Error identification
- Data collection
- Data processing
- Administrative support specialist
- Advanced clerical knowledge
- Multi-line phone proficiency
- Medical billing
- Data Entry
- Understands grammar
- Order processing
- Strong problem solver
- Claims appeal procedures
- Insurance processing
- Critical thinker
- Customer service-oriented
- Customer relationship management
- Employee management
- Excellent communication skills
- Strong interpersonal skills
- Resourceful
Timeline
Claims Specialist
Alera Group
04.2020 - 02.2022
Data Entry Specialist
Paychex Insurance Agency
02.2020 - Current
Claims Analyst I
Benefit Resources
01.2020 - 03.2020
Manage Care Specialist
Strong Memorial Hospital
02.2019 - 12.2019
Front Desk Medical Receptionist/billing Assistant
ALEXANDER MEDICAL GROUP
08.2018 - 01.2019
STRONG MEMORIAL HOSPITAL
10.2017 - 08.2018
Office Lead Registrar/Biller
WORKFIT MEDICAL
09.2015 - 10.2017
Patient Account Representative
Kelly Services
10.2010 - 09.2015
Similar Profiles
Hafsa YusufHafsa Yusuf
Insurance Agent at Paychex Insurance AgencyInsurance Agent at Paychex Insurance Agency
Ashley MorrisAshley Morris
PIA P&C Service Representative (PIAS Team) at Paychex Insurance AgencyPIA P&C Service Representative (PIAS Team) at Paychex Insurance Agency
Adrienne CollierAdrienne Collier
Health & Benefits Account Executive at Paychex Insurance AgencyHealth & Benefits Account Executive at Paychex Insurance Agency
Joshua KosarJoshua Kosar
Health Insurance Account Representative at Paychex Insurance AgencyHealth Insurance Account Representative at Paychex Insurance Agency
Kamaria EllisKamaria Ellis
PCA at Always Compassionate HealthcarePCA at Always Compassionate Healthcare