Yolanda Rushing

Via inbound/outbound answered 200+ calls and emails, provided payment information or denial reason to providers for worker compensation claims by reviewing explanation of review, resubmitted claims for reprocessing, entered and provided status of patient pre-authorization request, informed claimants and providers with in-network provider information.

• Demonstrated strong organizational and time management skills while managing multiple projects.
• Worked flexible hours across night, weekend.

• Processed approximately 50+ claims accordingly to establish approval or denial of medication. Verified health insurance, household income and other pertinent information. Submitted approval or denial letters to patients, doctors and insurance carriers.

Via inbound/outbound calls, 100+ provided payment information or denial reason to providers for worker compensation claims by reviewing explanation of review, resubmitted claims for reprocessing, entered and provided status of patient pre-authorization request, informed claimants and providers with in-network provider information.

Responsible for tracking and reporting carrier denial trends, entering paths to locate electronic EOB's, maintain file of paper EOB correspondence, tracking methods of carrier payments, obtaining required documentation to insurance carriers to pay invoice, assist Supervisor/Managers with monthly aging reports, credit/collection duties; data entry, outbound calls inquiring bill denial reasons, submit and re-submit invoices for initial processing or reconsideration, complete write-offs, other clerical finance duties upon request.

Responsible for creating and processing travel bills and manifest for road drivers. Entered over 400 bills per day.

Responsible for assisting patients and providers with explanation of benefit packages, mailing requested documents, authorizing patient visits, mailing/faxing requested documentation and other duties upon request.