Amber Gorman
Winder
Summary
A career with an institution or office where I can assist and succeed with my education, skills and experience.
Overview
19
19
years of professional experience
Work History
Revenue Recovery Specialist
Knowtion Health
07.2024 - Current
- Analyzed account discrepancies to recover outstanding revenue effectively.
- Developed and implemented strategies for optimizing collection processes.
- Collaborated with cross-functional teams to gather necessary documentation and evidence to support the appeals process.
- Achieved successful appeal outcomes by meticulously reviewing and analyzing claim denials, identifying errors, and presenting persuasive arguments.
- Demonstrated exceptional attention to detail when evaluating medical records in order to identify discrepancies or inconsistencies that could impact an appeal''s outcome positively or negatively.
- Maintained strict confidentiality of patient information in accordance with HIPAA regulations.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
NAC SCHEDULER
Northside Hospital
08.2022 - Current
- Worked with coworkers to complete tasks.
- Worked at checking timecards for accuracy to ensure staff is paid accordingly including submitting reports to payroll.
- Worked at staffing to ensure all shifts were covered.
- Provided support to staff members regarding their schedules or any changes that need to be made.
- Reviewed requests from employees for vacation time off or schedule changes in a timely manner.
- Managed calendars and organized resources to ensure efficient workflow processes.
- Monitored daily activities for adherence to established guidelines and procedures.
- Developed detailed plans for the scheduling of personnel in accordance with organizational objectives.
- Received and screened calls relating to problems that arose due to date changes.
APPEALS SPECIALIST
Premier Choice Billing
08.2019 - 04.2022
- Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions
- Monitored reports to identify claims issues and worked with adjusters to resolve problems
- Acted as intermediary between insurance companies and customers by researching and assessing information to determine claim validity
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients
- Verified policy holder data, including age, contact number and physical address
- Complied with confidentiality regulations in handling customer information
- Checked documentation for appropriate coding, catching errors and making revisions
- Instructed clients on amounts covered under benefits plans in easy-to-understand terminology
- Composed business correspondences for supervisors, managers and other professionals
- Modified, updated and processed existing policies and claims to reflect changes in beneficiary, amount of coverage and type of insurance
- Updated patient and insurance data and input changes into company's computer system
- Corresponded with insurance customers and agents to obtain or relay information on account status changes
- Precisely calculated refunds, premiums and adjustments
- Collaborated with fellow team members to manage large volume of claims
- Collected payments, processed receipts and informed policyholders of outstanding balances.
MEDICAL BILLING SPECIALIST
Abeo
03.2013 - 08.2021
- Worked in MedSuite software and updated pertinent details related to insurance, payment histories and personal or confidential information
- Liaised with patients, insurance companies and billing office personnel to effectively obtain payments and update system information
- Worked claims investigating and resolving issues to maintain billing accuracy
- Contacted insurance providers to verify correct insurance information and obtain any information regarding denials in order to submit claim correctly with needed information for processing and payment
- Including the submission of appeals and corrected claims
- Worked in Microsoft Excel in order to create spreadsheets for pain clinics advising them of the monies due from patient at the time of service
- Worked advising patients of past due balances, setting up payment plans and turning accounts over to our collection agencies depending on client
- Working with all insurance carriers to effectively get claims processed for payment and keeping the timely AR down.
SOFTLINES MANAGER
Sports Authority
04.2012 - 04.2014
- Works in helping customers based on their product needs
- Created and managed schedule for team of part-time and full-time employees
- Executed merchandising strategies and standards to decrease time to find products
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service
- Delegated work to staff, setting priorities and goals
- Remained calm and professional in stressful circumstances and when dealing with unhappy customers, effectively diffusing situations
- Treated associates with fairness and respect, providing recognition of accomplishments
- Planned and optimized warehouse work processes to improve fulfillment system efficiency
- Completed thorough opening, closing and shift change functions to maintain operational standards each day.
SALES ASSOCIATE
Snellville Fabric Mart
03.2009 - 11.2012
- Collected payments and provided accurate change
- Completed daily recovery tasks to keep areas clean and neat for maximum productivity
- Helped customers find specific products and offered product advice
- Arranged new merchandise with signage and appealing displays to encourage customer sales and move overstock items
- Sold various products by explaining unique features and educating customers on proper application or usage
- Built and maintained relationships with peers and upper management to drive team success
- Answered product questions with up-to-date knowledge of sales and promotions
- Built trusting relationships with customers by making personal connections
- Answered incoming telephone calls to provide store, products and services information
- Answered customer questions and responded quickly to problems and complaints in person, on phone and by email
- Placed orders and answered customer questions in-person, through email and over phone to maximize customer service
- Monitored customer order process and addressed customer issues
- Processed ACH, debit and credit card transactions for clients
- Handled credit and debit card payment processing to complete purchasing experience.
MANAGER
DDJ Fabrics
11.2011 - 04.2012
- Works helping customers pick out fabrics for their home
- Key Holder
- Examined merchandise to correctly price and display products
- Organized store and maintained high standards for cleanliness of parking lot, restroom and stockroom
- Delivered level of service to customers in effort to build upon relationships for future clients
- Worked day to day operations, such as the opening and closing of the store, counting the till and properly documenting the sales for that day.
SALES ASSOCIATE
Bath & Body Works
11.2008 - 01.2010
- Works in assisting customers with their product knowledge
- Assisted customers with purchasing merchandise based on their interest
- Worked on floor sets and setting up for new promotions overnight
- Collected payments and provided accurate change
- Completed daily recovery tasks to keep areas clean and neat for maximum productivity
- Built and maintained relationships with peers and upper management to drive team success
- Maintained knowledge of current promotions, exchange guidelines, payment policies and security practices
- Answered incoming telephone calls to provide store, products and services information.
MEDICAL ASSISTANT EXTERN
Complete Women's Healthcare
07.2008 - 10.2008
- Escorted patients to examination rooms and prepared for physician exams
- Charted all patient services in records with high accuracy
- Corresponded with patients through phone, fax, email and in person to schedule appointments and answer inquiries
- Assisted physicians by preparing patients for procedures, EKGs, phlebotomy, glucose testing and pulmonary function tests
- Sterilized instruments and disposed of contaminated supplies in adherence to OSHA regulations
- Monitored patient stability by checking vital signs and weight
- Measured specimens and delivered to laboratory
- Recorded patient temperature and blood pressure
- Performed finger sticks and used equipment to test blood for iron and protein levels
- Protected confidentiality of patient care information and treatments to prevent data breaches.
DAYCARE TEACHER
Discovery Point
08.2006 - 05.2008
- Communicated with children's parents and guardians about daily activities, behaviors and problems
- Supervised circle time, free play, outside play and learning and developmental activities
- Taught children foundational skills in colors, shapes and letters
- Organized and led activities to promote physical, mental and social development
- Implemented hands-on, play-based strategies for experiential learning
- Controlled classroom environments with clearly outlined rules and positive reinforcement techniques
- Sparked creativity and imagination by helping children discover new things each day
- Read aloud and played alphabet games to encourage early literacy
- Escorted children on outings and trips to promote enrichment and maintain safety
- Read stories to children and taught painting, drawing and crafts
- Maintained daily records of individual activities, behaviors, meals and naps
- Communicated with parents regularly to maintain student progress, schedule meetings and increase overall student happiness.
Education
MEDICAL ASSISTANT -
Everest Institute
Norcross, GA05.2008
HIGH SCHOOL DIPLOMA - undefined
South Gwinnett High School
Snellville, GA05.2006
Skills
- Insurance plan verification
- Patient rapport
- Documentation skills
- Skilled in MedSuite, Avid, MD Suite, Microsoft Excel
- Regulatory compliance understanding
- Database management
- Account management expertise
- Medicaid knowledge
- Leadership
- Work ethic
Timeline
Revenue Recovery Specialist
Knowtion Health
07.2024 - Current
NAC SCHEDULER
Northside Hospital
08.2022 - Current
APPEALS SPECIALIST
Premier Choice Billing
08.2019 - 04.2022
MEDICAL BILLING SPECIALIST
Abeo
03.2013 - 08.2021
SOFTLINES MANAGER
Sports Authority
04.2012 - 04.2014
MANAGER
DDJ Fabrics
11.2011 - 04.2012
SALES ASSOCIATE
Snellville Fabric Mart
03.2009 - 11.2012
SALES ASSOCIATE
Bath & Body Works
11.2008 - 01.2010
MEDICAL ASSISTANT EXTERN
Complete Women's Healthcare
07.2008 - 10.2008
DAYCARE TEACHER
Discovery Point
08.2006 - 05.2008
HIGH SCHOOL DIPLOMA - undefined
South Gwinnett High School
MEDICAL ASSISTANT -
Everest Institute