Linda Monroe Email & Phone Number

*Office Manager * Front desk: check clients in and out, schedule appointments, collect copayments, answer incoming calls, make outgoing calls, handle incoming referrals, collections, verify insurance, escalated calls.* Hire/Terminate employees, reviews for salary increases, mail, Bank Deposits, faxing, copying.* Handle Employee Assistance claims/billing. Submit all Insurance claims electronically and billing, Accounting, payroll, order all supplies. * Create schedules for all the counselors in the office for their appointment availability as well as co-ordinate office staff schedules.*Credentialing and anything else needed to be done.

*Claim Examiner Medicare Part B* Accurately examining, interpreting, and entering claims.* Resolve edits and first/second level suspense.* Research and effectively make decisions to properly adjudicate claims.* Adhere to and maintain production and quality standards.* Co-lead to the Operations Analyst, team of 6 examiners in which I answered questions for and held monthly team meetings.* Assisted Operations Analyst with MSP (Medicare Secondary Payor) training class.* Trainer for MSP (Medicare Secondary Payor) class *First Level Part B Triage (On loan to department from 10/11-03/12)*Identify and research appeal requests for FCSO (First Coast Service Options)* Identify Medicare Part A and FCSO’s subcontractor appeal requests.* Identify appeal requests that require additional documentation.* Transfer files and distribute requests to the appropriate area/work queue.* Adhere to and maintain production and quality standards.

*Customer Service Representative DSL Internet Services* Assist customers with registration, email creation, DSL physical line signal testing, modem/filter set-up. Assist customers with email, browser, and modem troubleshooting. Interact with other departments to resolve customer issues or provide additional services.* Mentor in the mentoring program to assist newly hired associates.* Service Lead Program assisting all co-workers with questions, escalations, and approving truck rolls for dispatch.

*Supervisor-Insurance Tracking Department*Maintain Personnel files, approve time sheets, interview candidates for open positions, administrative action for terminations, write and give annual performance reviews, held ongoing training classes, assisted with quality review of work, maintained the accounting system, data entry, answered escalated customer service calls and prioritizing responsibilities daily for the department, utilized Avaya phone system and CMS system for call center.*Completed Company provided courses in Lotus Notes, who moved my cheese and Customer Service. *Supervisor - Ordinary Department*Maintain Personnel files, approve time sheets, interview candidates for open positions, administrative action for terminations, write and give annual performance reviews, held ongoing training classes, answered escalated customer service calls and prioritizing responsibilities daily for the department, utilized the Avaya phone systems and CMS system for call center.*Completed Company provided course in Human Resources Supervisor’s legal rights and an offsite Supervisor’s seminar. *Claim Examiner *Processed claims such as STD, AD&D, HMS-Medical, Cancer, Critical Care, answered customer service calls, requested, and reviewed medical records for claim determination.*Completed Company provided course in Medical Terminology.

*Focus Development Coach*Trained examiners on how to process claims correctly, reviewed examiners work and answered questions for 40 claim examiners, held ongoing training classes, performed monthly meeting with claim examiners, handled escalated complaint issues with members and providers. *Quality Reviewer*Reviewed claim examiners work for errors, met with Focus Development Coaches to review claim examiner errors, maintained effective communication with the Provider Relations department for ongoing updates of the provider’s contracts. *Claim Examiner*Processed HMO/PPO medical claims, answered member customer service calls, answered provider phone calls, investigate claim appeals, and uphold production and quality standards.