Danielle Conway Email & Phone Number

Franklin, Tennessee, United States

Brentwood, Tennessee

• Utilized Denial, Underpayment, Credit Balance Claim Listing, EPO Tracking, and other reports to identify account problems and issues requiring follow-up.• Utilized Medicare’s DDE system to correct and adjust Medicare primary claims for payment.• Performed claim to claim and other adjustments to accounts as needed.• Research denials and underpayments, and file formal written appeals to insurance companies accordingly.• Assisted in negotiating Single Patient Agreements; work with Provider Relations representatives at insurance companies to solve coding and contract problems that cause underpayments.• Filed complaints with the Multi-State Department of Insurance against Multiple payors processing and paying claims incorrectly. • Utilized High Dollar report monthly to reduce High Dollar accounts with total balances over $50,000. • Examined and utilized contract knowledge to prepare and process refunds to insurance companies.• Communicated with leadership findings which would create a delay in payments from insurance companies.• Represented team as the SME for all Close Processes• Represented team for Multiple State payor guidelines and regulations• Understood and assisted teammates with Medicare Bundling rules and regulations as it pertains to lab values and Rx drugs.• Consistently updated patients insurance coverage when new insurance information was obtained• Monthly award for high cash collections over 150%• Received multiple Core Value and Teammate of the Month Award Verify primary and secondary and tertiary insurance.• Ensure that insurance string is correct according to Cob guidelines.• Consistently updated patients insurance coverage when new insurance information was obtained.• Generate reports to ensure all Medicare and Medicaid coverage is current before month end billing.• Responsible for timely insurance verification and obtain initial authorization for treatments and drugs.