Hi, I’m
Wendy Cook
Medical Administration
Selma,NC
Summary
Experienced Insurance Specialist, successful at excelling in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering over 25 years of experience and willingness to take on any challenge.
Overview
24
years of professional experience
Work History
US Oncology
Insurance Specialist Sr.
2015.02 - 2021.11 (6 years & 9 months)
Job overview
- Work newly denied claims daily to assure quick resolve and achieve maximum payment in a timely manner
- Work assigned spreadsheets weekly
- Review patient medical records to identify appropriate records to send for appeals
- Review all insurance correspondence to address any outstanding information needed to process their claim
- Submit adjustment requests for claims that are not able to be resolved after all avenues have been exhausted
- Work payment variances to ensure maximum payments are made according to contracted fee schedules
- Work all assigned buckets in accordance with company’s timely compliance guidelines
- Work closely with financial counselors to provide patients with all available resources to reduce patient balances
- Assist patients over the phone with any questions related to their account
- Submit 1st and 2nd level appeals as necessary for commercial and government carriers
- Identify errors on claims and submit charge corrections as necessary
- Work closely with payment posting to identify and correct all posting errors
- Work closely with supervisors to assist on all special projects assigned.
APM Spine & Sports Physicians
Patient Account Rep
2012.12 - 2014.07 (1 year & 7 months)
Job overview
- Print and work aging reports daily to follow-up on unpaid claims
- Set up payment arrangements for patients with large balances
- Post insurance payments from electronic and paper remits
- Fix claim edits to assure clean claims transmit to carriers electronically
- Worked with patients to help them understand their bill
- Submitted appeals and/or documentation to payers in a timely manner
- Ensured proper documentation within charts to comply with Medicare guidelines
- Worked extensive follow-up on Workers Compensation claims
- Worked front desk on the occasions that the practice was short staffed.
Oncology Associates of VA, P.C.
Patient Account Rep
1998.05 - 2012.09 (14 years & 4 months)
Job overview
- Traveled to clinic locations to perform charge capture
- Reviewed patient charts to ensure all appropriate documentation was present and compliant
- Reviewed and worked aging reports
- Investigated past due invoices to minimize the number of unpaid accounts
- Retrieved prior authorizations for outpatient procedures
- Accurately entered procedure codes, diagnosis codes and patient information into billing system
- Identified errors and refiled denied/rejected claims
- Posted and sent out all claims electronically
- Posted insurance payments from electronic and paper remits
- Submitted appeal and/or documentation to carriers as requested
- Submitted refund requests for claims overpaid in error
- Evaluated patient financial status and established appropriate payment plans
- Ensured timely and accurate charge submission.
Education
ECPI
05.1998
University Overview
- Certificate
- Business Accounting
- Healthcare Administration
- Medical Billing & Coding
- Transcription
Skills
- Documentation abilities
- Customer Service
- Health insurance
- Critical Thinking
- Insurance Coverage Verification
- Data Entry
- Billing Inquiries
- Insurance Eligibility
- Insurance Claim Regulations
- Documentation skills
- Account Management
Skills Highlights
- Strong work ethic
- Composed and professional demeanor
- Resourceful and reliable
- Team player with a positive attitude
- Strong attention to detail
- Multi-tasker
- Excellent problem solver
- Ability to work independently
Work Preference
Work Type
Full TimeWork Location
On-SiteRemoteHybridImportant To Me
Work-life balanceCareer advancementPaid time offPersonal development programsTeam Building / Company RetreatsTimeline
Insurance Specialist Sr.
US Oncology
2015.02 - 2021.11 (6 years & 9 months)
Patient Account Rep
APM Spine & Sports Physicians
2012.12 - 2014.07 (1 year & 7 months)
Patient Account Rep
Oncology Associates of VA, P.C.
1998.05 - 2012.09 (14 years & 4 months)
ECPI
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