Theresa Hallenbeck
Tolland,CT
Summary
Focused Medical Insurance Coordinator with 18 years' background in coordinating and processing insurance payments, facilitating billing and managing patient accounts. Proficient in liaising with patients, staff and insurance providers to maintain accounts and achieve optimal reimbursement. I am very goal oriented, having worked in a D-1 school handling all aspects of insurance coordination for over 800 student athletes. Prior to joining UConn I worked as a patient accounts biller for a local mental health hospital that treated both in-patient and out-patient services.
As a claims processor/adjuster I worked mainly with medical claims but was crossed trained to assist as needed to process dental claims. When I first started working with DGB it was in the call center. DGB was a TPA and all plans were specific to each employer.
Overview
24
24
years of professional experience
Work History
Insurance Coordinator
University of Connecticut, Dept. of Sports Medicin
Storrs , CT
2005.08 - 2023.06
- Provided customer service support by responding promptly to provider inquiries regarding authorization status or policy information.
- Developed strategies for streamlining workflow and improving efficiency in the department.
- Collaborated with providers to obtain missing information required for authorization submissions.
- Maintained a professional attitude when interacting with external customers such as physicians' offices or insurance companies.
- Participated in meetings with senior management to discuss current projects and develop action plans for implementation.
- Responded promptly to customer inquiries regarding billing issues or policy updates.
- Performed customer service duties such as answering inquiries, providing information and resolving customer complaints.
- Assisted in the preparation of insurance documents, including applications, claims forms and renewal notices.
- Developed and implemented strategies for improving customer service processes within the organization.
- Collaborated with other departments to coordinate services provided by external vendors or brokers.
- Maintained up-to-date knowledge of industry trends in order to provide customers with the best possible coverage options.
- Validated insurance and advised patients of benefits and coverage.
- Submitted claims to insurance companies and clearinghouses.
- Filed insurance claims by obtaining and entering data related to patient, insurance provider and medical code for procedures and services provided.
- Secured pre-authorizations and pre-certifications for minor surgical procedures performed in office settings.
Patient Accounts
Natchaug ospital
Mansfield Center , CT
2003.07 - 2005.08
- Performed data entry of patient demographics, insurance information, and account balances into computer system.
- Analyzed accounts for accuracy of coding and billing procedures.
- Researched discrepancies in accounts to ensure accurate payments.
- Processed incoming payments from patients and insurance companies.
- Communicated with customers regarding payment plans and past due accounts.
- Reconciled daily cash transactions and prepared daily bank deposits.
- Responded to inquiries from patients regarding their bills and other related matters.
- Reviewed monthly aging reports to determine which accounts are past due or require follow up action.
Insurance Claims Adjuster
Diversified Group Bokerage
Marlborogh , CT
2001.02 - 2003.07
- Reviewed and evaluated insurance claims for coverage, accuracy, completeness and compliance with company standards.
- Investigated the circumstances of insurance claims to determine liability.
- Analyzed policy language to determine applicable coverage and benefit levels.
- Interpreted medical records and legal documents related to insurance claims.
- Maintained accurate records of all claim activities in accordance with company guidelines.
Customer Service Representative
Diversified Group Broikerage
Marlborough , CT
1999.10 - 2001.02
- Answered customer inquiries and provided accurate information regarding products and services.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Developed effective working relationships with team members across multiple departments.
- Answered incoming calls from customers and provided assistance with product inquiries, billing questions, and other customer service related issues.
- Resolved customer complaints in a timely manner to ensure customer satisfaction.
Education
Medical Billing And Coding
Brandford Hall Career Institute
Windsor Locks, CT2000-10
Skills
- Dental insurance experience
- Insurance knowledge
- Insurance claims processing
- Financial Acumen
- CPT Coding
- Claims Processing
- ICD-10 Coding
- Policy administration
- Microsoft Office
- Medical billing proficiency
- Medical terminology proficiency
- Insurance Verification
- Customer service and assistance
Timeline
Insurance Coordinator
University of Connecticut, Dept. of Sports Medicin
2005.08 - 2023.06
Patient Accounts
Natchaug ospital
2003.07 - 2005.08
Insurance Claims Adjuster
Diversified Group Bokerage
2001.02 - 2003.07
Customer Service Representative
Diversified Group Broikerage
1999.10 - 2001.02
Medical Billing And Coding
Brandford Hall Career Institute
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