• Worked with patients to help them navigate the sometimes-complicated areas of healthcare as it relates to their claims and appeals procedures for their Durable Medical Equipment rentals, as well as Provider surgical billing by interacting with the patients throughout the entire claims and appeals process while working with Insures/Payors on their behalf. • Consistently displayed proper phone etiquette by implementing excellent listening and verbal communications skills as well as keeping strict adherence to Health Insurance Portability and Accountability Act (HIPAA), and Employee Retirement Income Security Act (ERISA) laws and regulations. • Upheld effectiveness when experiencing major changes in personal work tasks or work environment; adjusted effectively to work within new work structures, processes, requirements, software or cultures. Identified and understood issues, problems, and opportunities; compared data from different sources to draw conclusions; used effective approaches for choosing a course of action or developing appropriate solutions; and took action that is consistent with available facts, constraints, and probable consequences.

• Pharmacy prescription claim verification; reviewed, investigated, and analyzed worker’s compensation claims to maximize recovery. Daily processing of appeals and reconsideration's to insurers/payors for accounts receivables by acting as liaison between insurance carriers, pharmacy billing managers, patients, and internal divisions.• Negotiated settlements with insurance carriers within their granted settlement authority level and attended and participated in staff meetings, kept supervisor informed on status of all assigned cases and plan of action. Stayed up to date on new trends, pending litigation, HIPAA compliance, ERISA laws, risk management, and case law related to worker’s compensation or healthcare claims.• Developed and maintained internal systems for data collection, entry of financial analysis, and report generation, created, and updated spreadsheets, logs, aging, and daily diaries. Ensured invoices are on file and obtained status of medical billing less than 60 days outstanding by consistent follow-up.

• Received, and managed hospital claims associated with work related injuries by working with insurance carriers, recipients, fiscal agents, and providers to correct billing problems by interpreting policy, tracked and monitored parties responsible for outstanding claims. Obtained injury reports, medical records, hospital bills, insurance carrier documentation, and other records as needed; providing them to the payer organization. • Managed appeals and reconsiderations with outstanding accounts to ensure account resolution, and escalations with consistent follow-up. Built and maintained key customer relationships between providers, insurance carriers, and Law Firms. • Consistently kept up on industry knowledge, i.e. pricing and service offerings for competitive positioning. Continuously followed HIPAA and ERISA guidelines.

• Advocated continuously for their medical needs with medical facilities, practitioners, and payers.• Performed transportation logistics to and from medical appointments and hospital stays.• Inventory and ordering of medical supplies, as well as application. • Settled estate.

Administrative Assistant/Document Coordinator for Facilities/Finance Departments • Consistently provided a high level of judgment, diplomacy, confidentiality, and discretion in supporting Executive Management, as to any changes needed in their materials management processes. Excellent interpersonal, verbal, written and presentation skills. • Provided professional level of correspondence to Executive Management with a high degree of discretion, and confidentiality.• Performed back-up support for Comcast Receptionist as needed.