Dee A Bosold Email & Phone Number

Pennsylvania, United States

Reading, Pa

• Received and responded to incoming calls regarding power outages, customer inquiries, payment disputes, etc. • Processed move-ins and move-outs for new and existing customers; mainly payment troubled customers• Answered questions regarding customer’s bills and resolved or rebilled them according to company policy and PUC rules• Corrected bills utilizing the SAP R/3 system and set installment plans based on the customer’s ability to pay• Collected payments from checking accounts or credit card payments over the phone utilizing the NCO Financial system• Investigated prior balances using an external database to analyze and verify if a customer owed money from a prior account • Managed 2nd shift call volumes utilizing the IVR tools, CC Pulse, GIS View and the Live IVR link• Supported the advanced move in follow up team with zero justified PUC complaints while exceeding all goals• Reviewed financial summaries with customers and referred low income customers to appropriate assistance agencies• Called dispatchers on a daily basis regarding 911 emergencies, status of outages, location and eta of crews

Wyomissing, Pa

• Created a working patient pay log for outstanding debts owed to HEALTHSOUTH by patients• Contacted multiple insurance companies for claim status and supplied additional information as needed to pay our bill• Billed primary and secondary insurance carriers and followed up accordingly • Credentialed and re-credentialed radiologists as needed in a timely manner• Answered calls from patients and explained their bills to them• Entered write-off information monthly on a spreadsheet and after approval, adjusted off in the computer• Interviewed collection agency representatives and negotiated with them to choose the best one for HEALTHSOUTH• Brought down our Accounts Receivable by over $500,000.00 and collected over $250,000.00 in actual cash on old claims

Reading, Pa

• Handled medical and dental claim issues for 4500 + employees at 35 store locations, including but not limited to payment accuracy, HIPAA, ERISA, COBRA regulations, etc.• Started and completed a Summary Plan Description booklet for the self-funded portion of the employees’ health plan• Traveled to each Boscov’s store location twice a year for open enrollment periods to explain their benefits, answer any questions and respond to their concerns• Audited the insurance bills to make sure employees and or dependents were added or deleted on correct effective dates• Worked daily with the Benefits Administrator and Human Resource Managers on benefit related issues or problems• Coordinated meetings with the health insurance representative and the Human Resource Manager for each store• Established a reliable contact person at each of the insurance companies to fix all problems as they occurred• Responded promptly to employee walk-ins and phone calls regarding benefits, referral processes, network doctors, etc.• Helped employees get procedures/prescriptions pre-certified after they were initially denied by insurance• Prepared annual spreadsheets for all employees, spouses, children, etc., for year-end premiums• Filled out expense reports for company business reimbursements

Reading, Pa

• Entered effective and termination dates in the system to avoid claims being paid prior to or after their effective dates• Developed high level of medical and dental knowledge, including DME, ICD-9, CPT-4, DSM- III and ADA codes• Was in constant communication with the Human Resource Managers of our policyholders’ relative to member effective dates, termination dates, COBRA (payment or non-payment of premiums), Worker’s Compensation claims, etc.• Trained and audited new employees for our unit and reported their progress to my supervisor• Received recognition award for outstanding achievement in fraud detection • Authorized to process high dollar claims due to my experience, accuracy and attention to detail• Calculated reasonable and customary fees for certain medical, dental and surgical procedures to determine correct reimbursement to the member or provider• Supervised our unit of 15 employees during supervisor’s absence on several occasions, attended meetings and updated her on everything when she returned• Knowledgeable in all aspects of the health insurance field; PPO, Indemnity, HMO, Managed Care, Medicare, Medicaid, Individual Case Management, Temporary Disability Income, Worker’s Compensation, COBRA, Coordination of Benefits, etc.• Handled problem phone calls from members, attorneys, etc. and followed up accordingly until the issue was resolved• Analyzed surgical and medical procedures (operative reports and medical records) to determine correct coding, medical necessity and validity of claims• Adjusted and updated financial information in the computer relative to deductibles, lifetime maximums, etc.• Handled the overpayment and collection procedures; stop payments, tracers, follow up, etc. for our unit• Processed the Temporary Disability claims and followed up until members were back to work• Scheduled Independent Medical Exams for members as required by their plan for claimants on workmen’s compensation