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CURRENT RESUME
1. Retha D. Dowells-Coble
313 108th Ave NE, Blaine, MN 55434
Cell: (612) 695-1465
rethadowells@gmail.com, www.linkedin.com/in/retha-dowells-coble-69899a7
Summary
Organized Medical Billing and Appeals Specialist with extensive experience working in the medical devices industry.
Strong ability to manage multiple projects in high-pressure situations. Provided exemplary customer service when
interacting with various facilities and clients.
Key Qualifications
Medical: Verified / reviewed medical records, Medicare appeals / requirements, claims processing, insurance verification
Finance: Billing, negotiate payments, general ledger, reconciliation, medical payment collection, securities, petty cash
Insurance Knowledge: Health, life and disability insurance, Medicare, Medicaid
Administrative: Electronic filing, data entry, create spreadsheets, records management, coordinate conference / meetings
Customer Service: Call-center environment (insurance/medical/financial), telemarketing, and telecommunications.
Technical: Microsoft Office, RightFax, Availity, NaviNet, IDX BAR system, Apple and Microsoft search engines.
Professional Experience
Empi - Durable Medical Equipment, Shoreview, MN 8/2014 - 12/2015
Medicare Appeals Specialist / Reimbursement Specialist
Studied cases to determine the facts of each case and assesses issues involved in the case.
Reviewed files to determine whether all relevant information had been submitted.
Correctly matched denied items and arguments to Medicare policies.
Acquired all necessary information involved to appeal an adverse determination.
Used Internet and hard copy tools to research issues using federal laws and regulations relevant to CMS policies.
Primarily, worked with insurance and billing companies to determine the method of payment for patients.
Manually and electronically submitted claims for payment with required documentation.
Provided customer service to patients and clients with claims, payments and insurance information.
KForce Staffing/Contractor with McKesson Medical/Surgical, Golden Valley, MN 8/2013 - 6/2014
Documents/Reimbursement Specialist / Customer Service Representative
Reviewed certifications and clinical reports for accuracy in completion, and compliance to federal Medicare and
Medicaid guidelines.
Maintained accurate records for facility and physician contacts, filed and generated electronic documents, and
reconciled delivery tickets with invoices.
Processed invoiced billing for payment to subcontractors, Medicare, and Medicaid.
Customer Service Representative: Intake to qualify clients.
Maintained records for assigned facilities; ensured timely, accurate and appropriate product delivery.
Adhered to Medicare Part B compliance rules and regulations, and maintained a close, professional working
relationship with facility personnel.
Doherty Staffing for Data Recognition Corporation, Brooklyn Park, MN 3/2012 - 6/2012 & 3/2013 - 6/2013
Document Editor
Performed student achievement test editing, and documentation for procedural correctness.
AIL – American Income Life, Irving, TX 8/2012 - 2/2013
Licensed Insurance Agent (General Lines)
Educated potential clients on health, life and disability insurance, made recommendations and sold insurance.
TRI Marketing, Plymouth, MN 11/2011 - 02/2012
Telemarketer
Pre-selected dialer calls to solicit insurance quotes from various insurance providers (3 quotes per hour).
All Home Health, Inc., Bloomington, MN 11/2008 - 3/2011
Personal Care Attendant
Cleaned and dressed amputation wound, administered medications / intravenous medication, prepared meals,
light housekeeping, accompanied client to appointments, and assisted with grooming, hygiene and daily exercise.
2. Retha D. Dowells-Coble
Page 2
Additional Experience
House of Israel (self-founded non-profit), Minneapolis, MN 9/2008 - 08/2012
Executive Director
Provided leadership in developing program, organizational and financial plans with the Board of Directors and
staff, and carried out plans and policies.
Maintained official records and documents, and ensure compliance with federal, state and local regulations.
Kept the Board fully informed on the condition of the organization and all important factors.
Marketed the organization, and its’ programs.
Responsible for the recruitment, employment, and release of all personnel, both paid staff and volunteers.
Regular performance evaluations, and monitored human resource practices.
Developed and maintained sound financial practices, and program curricula.
Planned and coordinated various events
Spokesperso
Girls in Action, Minneapolis, MN 2006 - 2008
Mentor
Career coach for female junior and senior students at Roosevelt High School (in South Minneapolis).
Mentor to African-American female students at Patrick Henry High School (in North Minneapolis).
Motivational speaker at various elementary, high schools and school programs throughout the Minneapolis area.
Urban Ventures Leadership Council, Minneapolis, MN 2003 - 2006
Program Director - Director of “Women's Empowerment”.
Facilitate a group of women on how to use positive thought to make positive life choices and influx their lives, their
families and communities with positive life changes for peace, growth, stability, sustainability, prosperity and well-
being.
Advocate for women and children involved with county, child protection services, minor criminal offenses, etc.
(2006, yearly attendance record of 346 women).
Advocate, system navigator, counselor, consultant and motivational speaker.
Partnered with Hope Healing House (north Mpls.), as motivational speaker. Participated in the pilot program for
“Bridge Builders for Children”, which sought and trained mentors for children of incarcerated parents.
Resource Recovery Center (parenting class facilitator, through contract with Urban Ventures). Discussions focus
on discipline, spirituality, stress, safety and depression issues.
Teen mentor, with the Harriet Tubman Alliance Outreach program at Pilot City.
RBC Dain Rauscher, Inc., Minneapolis, MN 12/2001 - 3/2004
Senior Associate
Researched securities to determine worth, transfer and/or paying agent.
Assisted brokers in securing legal documents that validate securities.
Coordinated securities and Depository Trust Corporation factor changes for government securities by working
with the product areas and contra parties for clean-up of residual monies.
Monitored trade reconciliation reports, fail reports, open money and all other control measures.
Work with associates and fixed income operations to resolve issues in trade discrepancies.
Assisted government securities trade desk operations, during heavy volume periods and employee absence.
Education and Specialized Training
Corporate Training: Urban Ventures Sponsored Toast Masters training
Southern University, Baton Rouge, LA: Bachelor of Science Coursework
Kennedy-King College, Chicago, IL: AA in Business Administration
Moody Bible Institute: Certificate of Theology
Awards and Accomplishments
Abby Award from Abbott Northwestern Hospital/Allina
“Who’s Who in the Community Leadership” Award from Bethel University