Customer Service Workers Compensation
Resume:
Danielle Davis
Columbus, OH *****
ad9lfp@r.postjobfree.com
Work Experience
Bill Processor
Sedgwick - Dublin, OH
May 2018 to Present
Keys pre-coded billing data into the system. Identifies and forwards complex bills to claims examiners. Codes provider bills in accordance with claims management system notes and state guidelines. Follows workers compensation/auto guidelines to evaluate the services. Compares qualifications of service provider with service provided. Involved in system maintenance/file maintenance and interface with IT department. Assists in account batching and distribution of incoming and outgoing mail. ETA SPECIALIST
OhioHealth - Dublin, OH
May 2016 to April 2018
Receives and accurately processes cash receipts daily, posting all third party payors, private pays, and patient pays
impacting all facilities. Identifying and processing refunds on patient accounts to accurately resolve the account.
Enrollment Specialist
Mount Carmel Corp Services - Columbus, OH
October 2014 to May 2016
Responsible for enrollment application processing, including review, submission, tracking and correction, if necessary. Contacts prospective members to obtain missing or clarifying information. Maintains accurate and complete Enrollment and Eligibility records and files, in accordance with departmental standards. Openly communicates status of current work and outstanding issues to department head and other departments, as necessary. Files hardcopy materials timely and in accordance with department standards. Prepares written communications, as required per department standards, policies and procedures. Responsible for assigned inquires and prompt resolution to issues surfaced through review and system processing.
Quality Analyst
Chase - Columbus, OH
June 2011 to August 2014
Ensures business processes are adhering to all corporate, state and regulatory guidelines as well as applicable policies and procedures. Perform appropriate testing and validation, as assigned, of existing risks and controls to determine if they are accurately identified and that associated controls are in place to mitigate those risks.
Education
Some college
Skills
• Accounts Payable (5 years)
• Amisys (Less than 1 year)
• AS400 (Less than 1 year)
• Customer Service (5 years)
• Data Entry (10+ years)
• Workers' compensation claims (4 years)
• Healthcare Enrollment (2 years)
• Microsoft Word (10+ years)
• Microsoft Excel (10+ years)
• One Note (5 years)
• MicroSoft Teams (5 years)
• Strataware (5 years)
Additional Information
SKILLS/AWARDS
• Top Quality Award for the month of September 2012
• Quality score of 100% while meeting QA standards of Production
• Administrative skills -Oracle
• Microsoft Word -PowerPoint
• Excel Spreadsheets -Data Entry
• Access -10-key
• Windows 2000 -Customer Service
• Lotus -Accounts Payable
• AS400 - Voyager
• MARx -Amisys Advance
• AWD customer service
• Strataware
• Zebra
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