Summary
Overview
Work History
Skills
Timeline
Generic

Teresa Reier

Meeker,OK

Summary

Proven Reimbursement and Claim Professional. Was instrumental in recouping over 3 million dollars in back claims with Medicaid. Followed up with insurances daily to to ensure timely resolution. Skilled in identifying ans addressing issues that lead to claim denials. Well versed in analyzing denial reasons, coming up with strategies to address them and implementing corrective actions to prevent future denials. Adept at reviewing and interpreting payer policies to ensure compliance and optimize claim approval rates. Thorough understanding of timely filing and appeals deadlines, ensuring all claims and appeals are submitted within required timeframes. Strong ability to document all follow up actions, denials and appeals accurately.

Overview

41
41
years of professional experience

Work History

Pharmacy Technician

OptionCare
10.2024 - Current
  • Answered incoming phone calls and addressed questions from customers and healthcare providers.
  • Stocked, labeled, and inventoried medication to keep accurate records.
  • Enhanced pharmacy workflow by assisting pharmacists with medication dispensing, labeling, and packaging.
  • Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
  • Promoted patient confidentiality by adhering to HIPAA regulations when handling personal information during transactions.
  • Counted and labeled prescriptions with correct item and quantity.
  • Solved customer problems in-person or over telephone by providing assistance with placing orders, navigating systems, and locating items.
  • Assisted in maintaining a clean and organized work environment, ensuring compliance with safety regulations.
  • Increased overall pharmacy productivity by restocking supplies, organizing shelves, and maintaining cleanliness according to standards.
  • Performed wide range of pharmacy operations with strong commitment to accuracy, efficiency and service quality.
  • Provided exceptional customer service, fostering positive relationships with both new and returning patients at the pharmacy counter.
  • Entered and processed patients' prescriptions into internal system.
  • Improved patient satisfaction by efficiently processing prescriptions and managing inventory in a timely manner.
  • Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
  • Coordination verification and filling of more than 20 daily prescriptions in high volume infusion pharmacy environment.
  • Prepared packaging and labels for prescriptions, verifying accuracy of dosage, side effects, interactions, and refill instructions.

Intake Specialist

OptionCare Infusion
09.2003 - 05.2022
  • Entered all new patient information, verified insurance.
  • Collected, verified, recorded and processed client demographics, insurance payments, and referral information.
  • Created and adjudicated Medicare D and Medicaid pharmacy claims.
  • Ensured all claims billed were clean and compliant by learning and maintaining specific revenue cycle knowledge.
  • Initiated Prior Authorizations and followed up on denials and initiated appeals.
  • Worked with pharmacy staff to meet run times and ensure timely dispensing of all medicines.
  • Followed all applicable government regulations including HIPPA.
  • Worked with the facility staff and prescribers to obtain information needed to obtain authorizations in a timely manner.
  • Verified insurance coverage to ensure proper reimbursement.
  • Triaged at least 40 incoming phone calls and incoming faxes a day.
  • Scanned filed and electronically stored documents.
  • Resolved claim rejections and denials weekly.
  • Responsible for Cash posting and all EOB’s.
  • Communicated with patients to collect co-pays an outstanding balances, set up payment plans and explained charges.
  • Applied payments to appropriate accounts.
  • Identified and initiated refunds as appropriate.
  • Compiled documents for audits from third-party insurances.
  • Experience with I Emphsys, CPR +, Lewis software and limited knowledge with EPIC.
  • Provided compassionate support to clients during the intake process, offering reassurance and understanding in times of distress.

Billing Specialist

Heartland Healthcare
09.2000 - 09.2003
  • Researched and resolved billing discrepancies to enable accurate billing.
  • Identified, researched, and resolved billing variances to maintain system accuracy and currency.
  • Worked with multiple departments to check proper billing information.
  • Assisted colleagues in resolving complex billing issues, promoting teamwork and knowledge sharing within the department.
  • Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
  • Collaborated with the collections team to recover overdue payments from clients, maintaining cash flow and minimizing writeoffs.
  • Maintained detailed records of each account''s payment history, providing easy access to information for audit and analysis purposes.
  • Reduced errors in financial records by conducting regular audits of billed accounts.
  • Maintained up-to-date knowledge of billing regulations and compliance requirements, ensuring adherence to legal standards.

Receptionist

Harrah Home Health
02.1996 - 07.2000
  • Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
  • Answered phone promptly and directed incoming calls to correct offices.
  • Kept reception area clean and neat to give visitors positive first impression.
  • Resolved customer problems and complaints.
  • Streamlined front desk operations for increased efficiency by effectively managing phone calls, emails, and walk-in clients.
  • Responded to inquiries from callers seeking information.
  • Supported office efficiency by performing clerical tasks such as data entry, photocopying, scanning, and faxing documents.
  • Handled sensitive information with discretion while maintaining strict confidentiality standards.
  • Managed multiple tasks and met time-sensitive deadlines.

Video Store Manager

Country Boy Video
01.1990 - 12.1995
  • Established an efficient system for tracking late fees and following up with customers, reducing outstanding debts owed to the store.
  • Maintained a clean, well-organized store environment that encouraged repeat business from customers.
  • Resolved customer complaints in a professional manner, ensuring client satisfaction remained high.
  • Managed inventory and ordering for store merchandise, ensuring optimal stock levels at all times.
  • Enhanced customer retention by offering personalized recommendations based on their preferences and viewing history.
  • Built customer loyalty through exceptional service standards such as prompt assistance and addressing concerns proactively.

Apartment Leasing Agent

Apple Valley Apartments
06.1984 - 12.1988
  • Managed move-in and move-out processes efficiently, minimizing vacancies by coordinating unit turnovers quickly and effectively.
  • Collected monthly rent payments and other fees, always properly recording, and processing money.
  • Resolved conflicts between tenants regarding noise, encroachments, and parking.
  • Responded to messages and inquiries from various parties and used well-developed active listening and open-ended questioning skills to promote quick issue resolution.
  • Increased tenant satisfaction by promptly addressing maintenance requests and resolving issues in a timely manner.
  • Streamlined leasing processes by implementing efficient record-keeping methods, ensuring accurate documentation and reducing errors.
  • Inspected properties before and after new tenant move-ins to schedule maintenance, cleaners, and other services.
  • Developed strong relationships with potential tenants through personalized tours, providing detailed information about available units, amenities, and community features.
  • 4 to 5 move ins monthly with back ground checks.

Skills

  • Friendly, positive attitude
  • Teamwork and collaboration
  • Customer service
  • Problem-solving
  • Flexible and adaptable
  • Dependable and responsible
  • Critical thinking
  • Organizational skills
  • Calm under pressure
  • Organization and time management
  • Problem resolution

Timeline

Pharmacy Technician

OptionCare
10.2024 - Current

Intake Specialist

OptionCare Infusion
09.2003 - 05.2022

Billing Specialist

Heartland Healthcare
09.2000 - 09.2003

Receptionist

Harrah Home Health
02.1996 - 07.2000

Video Store Manager

Country Boy Video
01.1990 - 12.1995

Apartment Leasing Agent

Apple Valley Apartments
06.1984 - 12.1988

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Teresa Reier