1. Denise R. Forbes
1141 Baxter 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

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PATIENT ACCOUNTS REP | 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