Pamela Fail's Resume 2013
- 1. PAMELA FAILS 9109 Wesley Providence Parkway , Lithonia GA 30038 ▪ Phone: 678.206. 3308 ▪ failspamela@yahoo.com PROFESSIONAL SUMMARY Versatile, Results-Driven, Healthcare Professional with over 20 years of customer service and support experience. Proven track record of developing, implementing, and maintaining excellent relationships to ensure that account maintenance, problem-solving,trouble-shooting, sales staff support, and planning/implementation of proactive procedures and systems. Able to meet deadlines while monitoring data, maintaining confidentiality information electronically and paper files. Exceptional capacity to multi-task by managing numerous priorities with ease while providing superior service at all levels of organization. Excellent interpersonal, communication, and administrative skills such as developing a plan,conducting audits in a healthcare environment.. SUMMARY OF SKILLS Microsoft Office ~ Word ~ Word Perfect ~ Excel ~ PowerPoint ~ Emory Healthcare Systems ~EMR/Healthquest IDX~Medconnect~Web mail complete~PowerChart~I-Suite~Medical Terminology course EDUCATION AND PROFESSIONAL DEVELOPMENT University of Phoenix, Bachelor of Science in Health Management 04-2011 – 01-2013 (Graduation date) University of Phoenix, Associate of Art in Health Care Administration 09-15-2008 – 07 (Graduation date) Continue: Strayer University , Master of Health Services Administration/Management 2016 (Graduation date) PROFESSIONAL EXPERIENCE EMORY HEALTHCARE,(THE EMORY CLINIC), Decatur, GA Patient Account Representative II 11/2002-Present Receive inbound and outbound calls utilizing the Avaya Predictive dialing system Efficiently and effectively train new hire staff on the IDX,Avaya, and I-Suite software systems as well as the collection sections updating patient information in GECB Explain medical terminology to patients in reference to procedures and provide interpretation to patients about explaination of benefits Product verification (HMO,PPO,EPO) explaining billing processing (Private pay, Medciare,Medicaid) and supplement products Verified all insurance of patients using services Process a full knowledge of insurance guidelines and verification procedures with capability to discuss denial and rejection codes with patients Research and review denied claims,file claims and EOB’s as well as transfer balances to responsible parties Make daily collection verifications, research and complete all paperwork and forms to bill all types of claims for reimbursement SLEEP SCIENCES,Atlanta, GA Adminstrative Assistant /Billing Referral Coordinator 04/1998 – 10/2002 Performed various computer applications and maintained database for sleep study in Access Monitored accounts receivable performance and developed action plans if appropriate for any negative balances charge posting, compliance with regulatory standards and regulations, point of service payment collections, deposit validation and ensuring daily payment deposits Handled all EOB’s that were returned from insurance companies and made sure that all HCFA-1500 claim forms were processed in a timely manner .
- 2. Responsible for coordinating resources and communicating schedule changes and update PONY EXPRESS, Atlanta, GA Auto Liability/Administrative Assistant 03/1997 – 03/1998 Performed various computer applications and maintained database for auto accidents Developed and maintained filing system to maximize insurance and patient billing errors Created and electronic filing system for optimal organizational purposes Faxed and filled paperwork as needed Created and looked at disiciplinary action forms issued by the field locations for all claims References upon Request