Darla Roe

I have worked for At Home Quality Care, Inc. In Morris, IL, for 31 years, handling seven offices within the U.S. on a daily basis. I performed many job duties, including receptionist, customer service issues, insurance billing, Medicare billing, and also VA, private duty, and self-pay billing. I managed personnel files, assisted with payroll, OSHA, medical records requests, obtained prior authorizations, and performed insurance verifications through Availity and call centers with Aetna, BCBS, UHC, Humana, and many other insurance companies with a very fast response to intake. I also managed collections, appealing claim denials, collection agency referrals of delinquent accounts, and payment arrangements.

I was responsible for claim negotiations, proposals from insurance caseworkers, and contracts with outside medical groups.

Responsible for all the banking and monthly financials using Microsoft Excel software. I also designed all the spreadsheets, including payables, receivables, current balances, and aging. In charge of all incoming and outgoing mail.

I have knowledge of many different software programs, and medical software programs. CPT coding and some knowledge of ICD-10 coding.

• Provided excellent customer service to both internal and external customers.
• Reviewed medical records to determine if additional services are needed prior to making a referral.
• Advised staff on appropriate protocols when making a referral.
• Maintained confidentiality of patient information in compliance with HIPAA regulations.
• Collaborated with interdisciplinary teams to discuss patient care plans and adjust referral strategies as necessary.
• Answered questions and resolved concerns raised by both patients and specialists.
• Recruited, hired and trained new medical and facility staff.
• Educated patients on the referral process, including expected timelines and preparation for specialist visits.
• Adhered to HIPAA regulations when handling confidential patient information.
• Maintained accurate and up-to-date patient records, including referral status and follow-up information.