Teresa Rapach

• Review Bills and documentation daily, including workers' compensation and auto (PIP) bills while maintaining strong attention to detail and ensuring consistent quality and accuracy.
• Maintain strict confidentiality with sensitive client information, adhering to industry standards and company policies.
• Reduce turnaround time for reviews by effectively prioritizing tasks and managing deadlines.
• Support continuous improvement initiatives by actively participating in team meetings, trainings, and workshops focused on enhancing reviewer skills and processes.
• Sustained high levels of productivity under tight deadlines by efficiently using available resources.
• Enhanced customer satisfaction with prompt and accurate responses to inquiries.
• Resolved customer complaints, restoring confidence in services.

• Managed high call volumes for while providing exceptional customer support and maintaining professional composure.
• Handled escalated calls professionally, effectively resolving complex issues and ensuring client satisfaction at all times.
• Mastered multiple software systems for seamless navigation during calls, improving efficiency and reducing hold times for customers.
• Enhanced customer satisfaction by efficiently addressing and resolving inquiries in a timely manner.
• Established trust with clients by accurately addressing their concerns and offering appropriate resolutions based on their needs.
• Developed rapport with customers through empathetic listening skills, creating positive experiences even during difficult conversations.
• Collaborated with team members to share best practices and improve overall team performance in meeting targets.
• Educated customers about billing, payment processing and support policies and procedures.

• Opened files for new patients involved in MVAs.
• Faxed legal paperwork and maintained contact with providers involved in patients' treatment.
• Reviewed chiropractic and physical therapy treatment requests for medical necessity and causality and determined if care fell within NJ carepath guidelines.
• Reviewed surgical and more complicated treatment requests with nurses and/or physicians to determine medical necessity and causality.
• Faxed or emailed requests for information and determination letters.
• Followed up on files within appropriate timeframes to ensure compliance with NJ state mandates.
• Enhanced interdepartmental collaboration through effective communication with case managers, physicians, and billing departments.
• Nurtured strong professional relationships with insurance representatives, fostering a collaborative atmosphere during negotiations on behalf of patients.
• Increased accuracy of submitted claims through meticulous attention to detail in verifying insurance eligibility and benefits.

11/1999- 5/2002

• As a medical bill reviewer, then trainer, I reviewed and processed NJ PIP claims according to the NJ fee schedule and held several training classes for new employees teaching them to do same.

5/2002-12/2003

• As a supervisor, I supervised and co-managed six departments. My duties were, but not limited to: handling payroll, vacation scheduling, organizing duties and handling conference calls with clients.

12/2003-3/2007

• As a medical bill reviewer with the TCM dept, I verified that services were medically necessary and communicated with nurses and physicians.

I worked for New England Life where I was a claims processor from 1979-1988. The company was then purchased by Great West Life Assurance Co. in April of 1988 where I was a customer service representative until 11/1999.

As a customer service representative my duties were, but not limited to:

• Managing high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
• Handling escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
• Responding to customer requests for products, services, and company information.
• Developing strong product knowledge to provide informed recommendations based on individual customer needs.