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Denise R (2)
- 1. Denise R. Forbes 1141Baxter Lane #301 Knightdale, N.C. 27545 | 919-423-1049 | df13forbes@gmail.com Objective - A highly-qualified professional with over 10 years of excellent experience in the medical sector, looking for a position that will utilize my skills and knowledge. I have a strong capability of staying organized under pressure. I am competent and energetic with a demonstrated ability to perform medical and clerical tasks effectively while delivering outstanding customer service. Education DIPLOMA | 06/03/1990 | MOTHER SETON REGIONAL H.S. Some college courses: Healthcare Administration Key Skills Greeting patients Answering telephones Medical records management Medical terminology Pt Scheduling Organization Entering patient charges Data collection Confidentiality maintenance-HIPPA Chart prep/ EMR MS Office Typing-40 wpm Call center Real Med/NaviNet Insurance Verification Epic ICD 9 / ICD10/Billing HCPCS/CPT/Billing Grant Assistance Payment Posting Experience: FINANCIAL COUNSELOR/NAVIGATOR| UNC REX HOSPITAL| Cancer Center| NOV 2014-PRESENT Obtains and reviews authorizations for chemo drugs / provides clinicals Verifies insurance Follow-up on unpaid Chemotherapy claims Complete Financial Assistance applications for grants, copay assistance and free drug Provides up to date medical treatment costs and Insurance benefits Educates patients on government programs eligibility-Medicare, Medicaid INTAKE SPECIALIST-UTILIZATION MANAGEMENT | MANPOWER/BCBSNC | JAN 2014-JULY 2014| DURHAM, NC Answers incoming calls in high call volume from member and providers regarding requests for precertification of health services and medications Verifies member eligibility by accessing multiple eligibility systems Verifies status of professional and facility providers, to include accessing the National Provider Identifier (NPI) Answer inquiries and process requests received by phone or fax to provide callers with accurate , current information Gathering of appropriate case information received from members and providers Identifies and tasks precertification requests that warrant medicalnecessity review; clinical documentation Generates approvalletters to member/providers
- 2. Page 2 PATIENT ACCOUNTSREP | WAKEMED| MAY-2011-APRIL 2013| RALEIGH, NC Evaluating billed, unresolved claims and facilitating the resolution Review accounts that have received payments to determine proper action to be taken Perform daily inventory management for accounts assigned Identify missed payments or adjustments//trends and report transactions for posting Re-file claims and make corrections as necessary for prompt payment DEPARTMENT MANAGER | WALMART | NOVEMBER-2010-MAY2011 | Raleigh, NC Ensure associates are trained on department(s) procedures Completing price changes and Ordering merchandise in a timely manner Processing and stocking freight Recording/adding cost and retail inventory information Providing excellent customer service Following budgets for the department including shrinkbudget Developed 30-60-90 day merchandise plans / Planning and coordinating in-store promotions PATIENT ACCOUNTS REP | DUKE UNIVERSITY | MAY 2009-NOVEMBER 2010 | Durham, NC Checkin-out Copied, filed, distribute insurance cards Collect and post co-payments and balances on accounts due Schedule appointments/ obtained precertification / Insurance verification Follow-up on denied,unresolved claims, refiled , Reduced A/R SENIOR FINANCIAL COUNSELOR | NEWARK BETH ISRAEL HOSPITAL | JUNE-1999-JUNE 2006 | Newark, NJ Interview patients and family to complete registration (check-in/out) Obtain and confirm all demographicand financial information Provide excellent customer service Interview and evaluate patients insurance and financial needs Screened,evaluate and approved Medicaid/Charity Care applications Obtained precertification Surgery and appointment scheduling,to include diagnostic REFERENCES AVAILABLE UPON REQUEST