Misty Nelson618 Hawthorne Rd

Frankfort, IL. 60423

708-268-2351

jllybns0512@gmail.com

WORK EXPERIENCE______________________________________

Conifer Health Solutions- Tinley Park, IL. A/R Representative- Level II Third Party Follow Up- January 2016- Present

My core responsibility is to pursue reimbursement of services rendered and achieve accounts receivable resolution.

I perform follow up steps with insurance carriers and/or patients regarding open accounts receivable and/or delinquent accounts to result in maximum cash collections for our clients.

Contact insurance carriers through websites, email, or telephone to resolve outstanding accounts

Analyze and resolve insurance denials Appeal and/or resubmit unresolved invoices to insurance carriers Research and respond to insurance correspondence Update registration information, post EOB denial codes and adjustments in practice

management systems. Currently working in Athena Research and obtain required documents to resolve misdirected payment issues May provide internal coverage for customer service calls Train all new employees Solid analytical and problem solving skills to recognize trends. Efficiency using Excel and Word for reports & logs

Conifer Health Solutions- Tinley Park, IL. Customer Service Representative III Team Lead- July 2015- January 2016

I am the team lead for a high volume call center team for Vanguard Athena , Epic, and Intergy system experience Assist patients with account concerns such as payments, coding issues, disputes,

payment plans, etc. Handle all escalated patient calls & coach agents when needed Handle patient disputes , HIPAA, coding issues, patient refund escalations and

missing money cases Train all new hires & continue to assist my team on the floor with any questions or

additional training they may need Efficiency using Excel and Word for reports & logs

Process patient bankruptcy correspondence, Refund escalation forms, and attorney requests.

I am a believer of positive moral for my team and assist with moral boosting concepts such as customer service week, recognition bulletin boards, encouragement emails, and occasional luncheons.

Conifer Health Solutions- Tinley Park, IL.Customer Service Representative- March 2015- July 2015

Customer service representative for a high volume call center for the Vanguard team

Assist patients with payments & billing questions or concerns Route patient disputes, coding issues, HIPAA, patient refunds, missing money cases

to the appropriate party Assist patients with financial concerns regarding their outstanding balances.

Offering payment plans or Charity care options

Family Wellness Center a Division of Family Chiropractic, LTD. Homer Glen IL.

Office Manager/ Chiropractic assistant - March 2013 - Present

HIPAA compliance officer. Maintain quarterly HIPAA audits ACOM , Gateway, & Availity system experience Greet visitors, ascertain purpose of visit, and direct them to appropriate staff. Complete insurance or other claim forms. Interview patients to complete documents, case histories, or forms, such as

intake or insurance forms. Receive and route messages or documents, such as laboratory results, to

appropriate staff. Setting up and calibrating the Med-X lumbar and cervical machines Compile and record medical charts, reports, or correspondence, using

typewriter or personal computer. Transmit correspondence or medical records by mail, e-mail, or fax. Maintain medical records, technical library, or correspondence files. Perform various clerical or administrative functions, such as ordering and

maintaining an inventory of supplies. Perform bookkeeping duties, such as credits or collections, preparing and

sending patients financial statements or bills, and keeping financial records. Process daily bank deposits Manage the staff schedules and vacations Assist patient with claim issues and insurance denials Process insurance bulk checks & EOB’s Insurance verifications via Availity or outbound calls made to the patients

insurance carrier

Direct patients to the proper chiropractic rooms, massage, pool or gym Assist the doctor with supplies being sure to have ice packs, gowns, shorts,

EMS sponges, and Interferential pads available for each patient Hold monthly staff meetings Request and obtain medical records from other healthcare facilities such as

X-ray reports, MRI reports or CT scan reports Schedule patients and being sure to follow up with patients to be sure they

stay on track with the doctors recommended treatment plan Collections. Call delinquent patients in effort to get payment on the past due

account Watch the building while the doctor is out of town. Changing the security

tapes, logging the pressure of the pool pumps, cleaning the building, laundry

State Farm Insurance- Bob Davis, Orland Park IL.

Sales & Service Manager August 2000 - March 2013

Interview prospective clients to obtain data about their financial resources and needs, the physical condition of the person or property to be insured, and to discuss any existing coverage.

Illinois state license to sell Auto, Life, Fire, Health Insurance, and Bank products

Call on policyholders to deliver and explain policy, to analyze insurance program and suggest additions or changes, or to change beneficiaries.

Seek out new clients and develop clientele by networking to find new customers and generate lists of prospective clients.

Ensure that policy requirements are fulfilled, including any necessary medical examinations and the completion of appropriate forms.

Market and create sales events in effort to promote the agent and his office Create sales contests and promotion in effort to create a fun work

environment for staff that creates a motivation to sell more insurance Customize insurance programs to suit individual customers, often covering a

variety of risks. Explain features, advantages and disadvantages of various policies to

promote sale of insurance plans. Calculate premiums and establish payment method. Inspect property, examining its general condition, type of construction, age,

and other characteristics, to decide if it is a good insurance risk. Perform administrative tasks, such as maintaining records and handling

policy renewals. Develop marketing strategies to compete with other individuals or companies

who sell insurance. Contact underwriter and submit forms to obtain binder coverage. Monitor insurance claims to ensure they are settled equitably for both the

client and the insurer. Attend meetings, seminars and programs to learn about new products and

services, learn new skills, and receive technical assistance in developing new accounts.

Call past due clients in effort to obtain a payment on the past due account Collect oral specimen for life insurance via cotton swab of the saliva

Daily Bank deposits and ordering of office supplies Lead sales person in the office resulting to sales awards and top bonuses

EDUCATION______________________________________________

Reavis High School, Burbank IL.

Additional Skills___________________________________________

Single handedly put together a successful Red Cross blood drive event. This brought community awareness of our State Farm office leading to many sales leads while assisting the lives of over 90 people in the need of blood.

Marketing of the Lifetime Fitness 5K runs Marketing booth at LA Boxing customer appreciation nights