SlideShare a Scribd company logo
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.
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

More Related Content

What's hot

Phyllis D. Franke Resume
Phyllis D. Franke ResumePhyllis D. Franke Resume
Phyllis D. Franke ResumePhyllis Franke
 
Juan Carlos Rosa Resume2
Juan Carlos Rosa Resume2Juan Carlos Rosa Resume2
Juan Carlos Rosa Resume2juan rosa
 
Alicia%20Eldridge%20Resume[1]
Alicia%20Eldridge%20Resume[1]Alicia%20Eldridge%20Resume[1]
Alicia%20Eldridge%20Resume[1]Alicia Eldridge
 
Francine pratts 2016 resume
Francine pratts 2016 resumeFrancine pratts 2016 resume
Francine pratts 2016 resume
Francine Pratts
 
Ashley's resume.docx - Hword 2014
Ashley's resume.docx - Hword 2014Ashley's resume.docx - Hword 2014
Ashley's resume.docx - Hword 2014Ashley Matthews
 
Patricia (Tish) DiRenzo resume
 Patricia (Tish) DiRenzo resume Patricia (Tish) DiRenzo resume
Patricia (Tish) DiRenzo resume
Patricia (Tish) DiRenzo
 
resume2pierceupdated08172016
resume2pierceupdated08172016resume2pierceupdated08172016
resume2pierceupdated08172016brenda johnson
 

What's hot (18)

RESUME 2016
RESUME 2016RESUME 2016
RESUME 2016
 
resumedetailsept15
resumedetailsept15resumedetailsept15
resumedetailsept15
 
RESUME 09 22 2016
RESUME 09 22 2016RESUME 09 22 2016
RESUME 09 22 2016
 
Phyllis D. Franke Resume
Phyllis D. Franke ResumePhyllis D. Franke Resume
Phyllis D. Franke Resume
 
Juan Carlos Rosa Resume2
Juan Carlos Rosa Resume2Juan Carlos Rosa Resume2
Juan Carlos Rosa Resume2
 
resume 021116
resume 021116resume 021116
resume 021116
 
resume 2015 1
resume 2015 1resume 2015 1
resume 2015 1
 
Alicia%20Eldridge%20Resume[1]
Alicia%20Eldridge%20Resume[1]Alicia%20Eldridge%20Resume[1]
Alicia%20Eldridge%20Resume[1]
 
Francine pratts 2016 resume
Francine pratts 2016 resumeFrancine pratts 2016 resume
Francine pratts 2016 resume
 
Sandra Fuller -OC
Sandra Fuller -OCSandra Fuller -OC
Sandra Fuller -OC
 
Ashley's resume.docx - Hword 2014
Ashley's resume.docx - Hword 2014Ashley's resume.docx - Hword 2014
Ashley's resume.docx - Hword 2014
 
Patricia (Tish) DiRenzo resume
 Patricia (Tish) DiRenzo resume Patricia (Tish) DiRenzo resume
Patricia (Tish) DiRenzo resume
 
Resume11-12-15
Resume11-12-15Resume11-12-15
Resume11-12-15
 
Rosa Rodriguez Resume
Rosa Rodriguez ResumeRosa Rodriguez Resume
Rosa Rodriguez Resume
 
resume2pierceupdated08172016
resume2pierceupdated08172016resume2pierceupdated08172016
resume2pierceupdated08172016
 
Carolyn_Resume
Carolyn_ResumeCarolyn_Resume
Carolyn_Resume
 
new res va other
new res va othernew res va other
new res va other
 
resume 2015 (1)
resume 2015 (1)resume 2015 (1)
resume 2015 (1)
 

Similar to CURRENT RESUME

Janine K Stark Resume
Janine K Stark ResumeJanine K Stark Resume
Janine K Stark ResumeJanine Starks
 
Denise's Original Pro Sequential Resume_052115
Denise's Original Pro Sequential Resume_052115Denise's Original Pro Sequential Resume_052115
Denise's Original Pro Sequential Resume_052115
Denise Josephs
 
Manish S. Patel Resume
Manish S. Patel ResumeManish S. Patel Resume
Manish S. Patel Resume
Manish S. Patel, MBA
 
Psychology Cv 21 (1)
Psychology Cv 21 (1)Psychology Cv 21 (1)
Psychology Cv 21 (1)Renee Jenkins
 
Resume-April 2015[1]
Resume-April 2015[1]Resume-April 2015[1]
Resume-April 2015[1]Laura Alcoser
 
hortas 08172015 anthem ii
hortas 08172015 anthem iihortas 08172015 anthem ii
hortas 08172015 anthem iiSalvador Horta
 
Mary Anne Davis Resume 8.26.2015 (1) (1)
Mary Anne Davis Resume 8.26.2015 (1) (1)Mary Anne Davis Resume 8.26.2015 (1) (1)
Mary Anne Davis Resume 8.26.2015 (1) (1)mary davis
 
Curriculum vitae javier c
Curriculum vitae  javier cCurriculum vitae  javier c
Curriculum vitae javier c
Javier Curras
 
Curriculum vitae javier c
Curriculum vitae  javier cCurriculum vitae  javier c
Curriculum vitae javier c
Javier Curras
 
Lisa K Sipp (2) resume dol
Lisa K Sipp (2) resume dolLisa K Sipp (2) resume dol
Lisa K Sipp (2) resume dolLisa Sipp
 

Similar to CURRENT RESUME (20)

Janine K Stark Resume
Janine K Stark ResumeJanine K Stark Resume
Janine K Stark Resume
 
Denise's Original Pro Sequential Resume_052115
Denise's Original Pro Sequential Resume_052115Denise's Original Pro Sequential Resume_052115
Denise's Original Pro Sequential Resume_052115
 
Manish S. Patel Resume
Manish S. Patel ResumeManish S. Patel Resume
Manish S. Patel Resume
 
Res 1
Res 1Res 1
Res 1
 
Crystal Westmoreland Resume 2016
Crystal Westmoreland Resume 2016Crystal Westmoreland Resume 2016
Crystal Westmoreland Resume 2016
 
Updated Awesome Resume
Updated Awesome ResumeUpdated Awesome Resume
Updated Awesome Resume
 
Psychology Cv 21 (1)
Psychology Cv 21 (1)Psychology Cv 21 (1)
Psychology Cv 21 (1)
 
kyounger resume
kyounger resumekyounger resume
kyounger resume
 
Robinson 2015 Resume
Robinson 2015 ResumeRobinson 2015 Resume
Robinson 2015 Resume
 
Robinson 2015 Resume
Robinson 2015 ResumeRobinson 2015 Resume
Robinson 2015 Resume
 
Resume-April 2015[1]
Resume-April 2015[1]Resume-April 2015[1]
Resume-April 2015[1]
 
Melanie D Resume 012017
Melanie D Resume 012017Melanie D Resume 012017
Melanie D Resume 012017
 
Burton Resume
Burton ResumeBurton Resume
Burton Resume
 
hortas 08172015 anthem ii
hortas 08172015 anthem iihortas 08172015 anthem ii
hortas 08172015 anthem ii
 
Mary Anne Davis Resume 8.26.2015 (1) (1)
Mary Anne Davis Resume 8.26.2015 (1) (1)Mary Anne Davis Resume 8.26.2015 (1) (1)
Mary Anne Davis Resume 8.26.2015 (1) (1)
 
Denise Res jan 15
Denise Res jan 15Denise Res jan 15
Denise Res jan 15
 
Resume_2016_2pp
Resume_2016_2ppResume_2016_2pp
Resume_2016_2pp
 
Curriculum vitae javier c
Curriculum vitae  javier cCurriculum vitae  javier c
Curriculum vitae javier c
 
Curriculum vitae javier c
Curriculum vitae  javier cCurriculum vitae  javier c
Curriculum vitae javier c
 
Lisa K Sipp (2) resume dol
Lisa K Sipp (2) resume dolLisa K Sipp (2) resume dol
Lisa K Sipp (2) resume dol
 

Recently uploaded

Cardiac Arrhythmias (2).pdf for nursing student
Cardiac Arrhythmias (2).pdf for nursing studentCardiac Arrhythmias (2).pdf for nursing student
Cardiac Arrhythmias (2).pdf for nursing student
fahmyahmed789
 
the IUA Administrative Board and General Assembly meeting
the IUA Administrative Board and General Assembly meetingthe IUA Administrative Board and General Assembly meeting
the IUA Administrative Board and General Assembly meeting
ssuser787e5c1
 
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to Care
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareLGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to Care
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to Care
VITASAuthor
 
一比一原版纽约大学毕业证(NYU毕业证)成绩单留信认证
一比一原版纽约大学毕业证(NYU毕业证)成绩单留信认证一比一原版纽约大学毕业证(NYU毕业证)成绩单留信认证
一比一原版纽约大学毕业证(NYU毕业证)成绩单留信认证
o6ov5dqmf
 
Cold Sores: Causes, Treatments, and Prevention Strategies | The Lifesciences ...
Cold Sores: Causes, Treatments, and Prevention Strategies | The Lifesciences ...Cold Sores: Causes, Treatments, and Prevention Strategies | The Lifesciences ...
Cold Sores: Causes, Treatments, and Prevention Strategies | The Lifesciences ...
The Lifesciences Magazine
 
Feeding plate for a newborn with Cleft Palate.pptx
Feeding plate for a newborn with Cleft Palate.pptxFeeding plate for a newborn with Cleft Palate.pptx
Feeding plate for a newborn with Cleft Palate.pptx
SatvikaPrasad
 
Letter to MREC - application to conduct study
Letter to MREC - application to conduct studyLetter to MREC - application to conduct study
Letter to MREC - application to conduct study
Azreen Aj
 
ABDOMINAL COMPARTMENT SYSNDROME
ABDOMINAL COMPARTMENT SYSNDROMEABDOMINAL COMPARTMENT SYSNDROME
ABDOMINAL COMPARTMENT SYSNDROME
Rommel Luis III Israel
 
PrudentRx's Function in the Management of Chronic Illnesses
PrudentRx's Function in the Management of Chronic IllnessesPrudentRx's Function in the Management of Chronic Illnesses
PrudentRx's Function in the Management of Chronic Illnesses
PrudentRx Program
 
Luxurious Spa In Ajman Chandrima Massage Center
Luxurious Spa In Ajman Chandrima Massage CenterLuxurious Spa In Ajman Chandrima Massage Center
Luxurious Spa In Ajman Chandrima Massage Center
Chandrima Spa Ajman
 
Top massage center in ajman chandrima Spa
Top massage center in ajman chandrima  SpaTop massage center in ajman chandrima  Spa
Top massage center in ajman chandrima Spa
Chandrima Spa Ajman
 
定制(wsu毕业证书)美国华盛顿州立大学毕业证学位证书实拍图原版一模一样
定制(wsu毕业证书)美国华盛顿州立大学毕业证学位证书实拍图原版一模一样定制(wsu毕业证书)美国华盛顿州立大学毕业证学位证书实拍图原版一模一样
定制(wsu毕业证书)美国华盛顿州立大学毕业证学位证书实拍图原版一模一样
khvdq584
 
Champions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdf
Champions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdfChampions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdf
Champions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdf
eurohealthleaders
 
POLYCYSTIC OVARIAN SYNDROME (PCOS)......
POLYCYSTIC OVARIAN SYNDROME (PCOS)......POLYCYSTIC OVARIAN SYNDROME (PCOS)......
POLYCYSTIC OVARIAN SYNDROME (PCOS)......
Ameena Kadar
 
Veterinary Diagnostics Market PPT 2024: Size, Growth, Demand and Forecast til...
Veterinary Diagnostics Market PPT 2024: Size, Growth, Demand and Forecast til...Veterinary Diagnostics Market PPT 2024: Size, Growth, Demand and Forecast til...
Veterinary Diagnostics Market PPT 2024: Size, Growth, Demand and Forecast til...
IMARC Group
 
KEY Points of Leicester travel clinic In London doc.docx
KEY Points of Leicester travel clinic In London doc.docxKEY Points of Leicester travel clinic In London doc.docx
KEY Points of Leicester travel clinic In London doc.docx
NX Healthcare
 
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Navigating Challenges: Mental Health, Legislation, and the Prison System in B...
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...
Guillermo Rivera
 
CANSA support - Caring for Cancer Patients' Caregivers
CANSA support - Caring for Cancer Patients' CaregiversCANSA support - Caring for Cancer Patients' Caregivers
CANSA support - Caring for Cancer Patients' Caregivers
CANSA The Cancer Association of South Africa
 
PET CT beginners Guide covers some of the underrepresented topics in PET CT
PET CT  beginners Guide  covers some of the underrepresented topics  in PET CTPET CT  beginners Guide  covers some of the underrepresented topics  in PET CT
PET CT beginners Guide covers some of the underrepresented topics in PET CT
MiadAlsulami
 
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...
ILC- UK
 

Recently uploaded (20)

Cardiac Arrhythmias (2).pdf for nursing student
Cardiac Arrhythmias (2).pdf for nursing studentCardiac Arrhythmias (2).pdf for nursing student
Cardiac Arrhythmias (2).pdf for nursing student
 
the IUA Administrative Board and General Assembly meeting
the IUA Administrative Board and General Assembly meetingthe IUA Administrative Board and General Assembly meeting
the IUA Administrative Board and General Assembly meeting
 
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to Care
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareLGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to Care
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to Care
 
一比一原版纽约大学毕业证(NYU毕业证)成绩单留信认证
一比一原版纽约大学毕业证(NYU毕业证)成绩单留信认证一比一原版纽约大学毕业证(NYU毕业证)成绩单留信认证
一比一原版纽约大学毕业证(NYU毕业证)成绩单留信认证
 
Cold Sores: Causes, Treatments, and Prevention Strategies | The Lifesciences ...
Cold Sores: Causes, Treatments, and Prevention Strategies | The Lifesciences ...Cold Sores: Causes, Treatments, and Prevention Strategies | The Lifesciences ...
Cold Sores: Causes, Treatments, and Prevention Strategies | The Lifesciences ...
 
Feeding plate for a newborn with Cleft Palate.pptx
Feeding plate for a newborn with Cleft Palate.pptxFeeding plate for a newborn with Cleft Palate.pptx
Feeding plate for a newborn with Cleft Palate.pptx
 
Letter to MREC - application to conduct study
Letter to MREC - application to conduct studyLetter to MREC - application to conduct study
Letter to MREC - application to conduct study
 
ABDOMINAL COMPARTMENT SYSNDROME
ABDOMINAL COMPARTMENT SYSNDROMEABDOMINAL COMPARTMENT SYSNDROME
ABDOMINAL COMPARTMENT SYSNDROME
 
PrudentRx's Function in the Management of Chronic Illnesses
PrudentRx's Function in the Management of Chronic IllnessesPrudentRx's Function in the Management of Chronic Illnesses
PrudentRx's Function in the Management of Chronic Illnesses
 
Luxurious Spa In Ajman Chandrima Massage Center
Luxurious Spa In Ajman Chandrima Massage CenterLuxurious Spa In Ajman Chandrima Massage Center
Luxurious Spa In Ajman Chandrima Massage Center
 
Top massage center in ajman chandrima Spa
Top massage center in ajman chandrima  SpaTop massage center in ajman chandrima  Spa
Top massage center in ajman chandrima Spa
 
定制(wsu毕业证书)美国华盛顿州立大学毕业证学位证书实拍图原版一模一样
定制(wsu毕业证书)美国华盛顿州立大学毕业证学位证书实拍图原版一模一样定制(wsu毕业证书)美国华盛顿州立大学毕业证学位证书实拍图原版一模一样
定制(wsu毕业证书)美国华盛顿州立大学毕业证学位证书实拍图原版一模一样
 
Champions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdf
Champions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdfChampions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdf
Champions of Health Spotlight On Leaders Shaping Germany's Healthcare.pdf
 
POLYCYSTIC OVARIAN SYNDROME (PCOS)......
POLYCYSTIC OVARIAN SYNDROME (PCOS)......POLYCYSTIC OVARIAN SYNDROME (PCOS)......
POLYCYSTIC OVARIAN SYNDROME (PCOS)......
 
Veterinary Diagnostics Market PPT 2024: Size, Growth, Demand and Forecast til...
Veterinary Diagnostics Market PPT 2024: Size, Growth, Demand and Forecast til...Veterinary Diagnostics Market PPT 2024: Size, Growth, Demand and Forecast til...
Veterinary Diagnostics Market PPT 2024: Size, Growth, Demand and Forecast til...
 
KEY Points of Leicester travel clinic In London doc.docx
KEY Points of Leicester travel clinic In London doc.docxKEY Points of Leicester travel clinic In London doc.docx
KEY Points of Leicester travel clinic In London doc.docx
 
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Navigating Challenges: Mental Health, Legislation, and the Prison System in B...
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...
 
CANSA support - Caring for Cancer Patients' Caregivers
CANSA support - Caring for Cancer Patients' CaregiversCANSA support - Caring for Cancer Patients' Caregivers
CANSA support - Caring for Cancer Patients' Caregivers
 
PET CT beginners Guide covers some of the underrepresented topics in PET CT
PET CT  beginners Guide  covers some of the underrepresented topics  in PET CTPET CT  beginners Guide  covers some of the underrepresented topics  in PET CT
PET CT beginners Guide covers some of the underrepresented topics in PET CT
 
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...
 

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