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lorna cotto

lorna cotto

Resolution Specialist


St. Cloud, FL

Resolution Specialist at Walgreens



Resolution Specialist

• Primarily responsible for resolving Third party Rejects (TPRs)
• Responsible for reviewing the Third Party Rejections, gathering information, making corrections, and resubmitting.
• Responsible for making telephone calls as necessary.
• Responsible for following all guidelines and procedures for resolving third party insurance rejects
• Must be able to read and understand Walgreens prescription data entry guidelines and procedures; applies and maintains appropriate licensure/registration, as required by state regulations.
• Must have the ability to interprets medical abbreviations (SIG codes)
• Answering inbound calls and voicemails from customers.

Career medium 02
Career medium 03

dr. fernandez

medical billing clerk

• Responsible for the maintenance of the patient's documents and their addresses.
• Maintained the patient's information, reports, income reports and statistics with balancing the daily schedule.
• Processed patient's billing, statements, reimbursement claims, post transaction and data.
• Deals with the queries and respond to them by telephone or by writing.
• Responsible for the reports distribution, telephone and generation of the bills.
• Responsible for the maintenance of the records of the patients, billing instructions etc.
• Maintained the special bill's lists, customers account, etc.
• Also responsible for the answering the customers queries, complaints and problems.
• Reviewed patient medical records for completeness, accuracy and regulatory compliance
• Retrieved patient medical records for physicians, technicians, staff
• Protected the security of medical records to ensure confidentiality.
• Planned, developed, maintained and operated a variety of health record indexes and storage and retrieval systems to collect, classify, store and analyze information
• Computer entry of demographics, history and extent of disease, diagnostic procedures and treatment
• Compiled and maintained patients' medical records to document condition and treatment, providing data for research, cost control and care improvement
• Handled patient admission, discharge forms
• Assigned the patient to diagnosis-related groups using appropriate computer software.
• Released information to individuals, agencies in compliance with appropriate regulations
• Coded all daily clinic visits/ancillary visits using ICD-9, CPT-4 reference books and the 3M Encoder to assign codes
• Sequenced diagnosis/procedures for the outpatient medical records according to coding guidelines
• Worked with physicians, nursing staff to clarify/correct records
• Entered data for billing purposes
• Updated policy and procedure manuals



customer service representative

• Provided support to the sales team, ensuring all sales and service objectives were met.
• Responsible for customer service in the digital equipment division, duties included answering customer queries, problem solving and providing detailed information on new products.
• Worked with new customers in the development of new accounts and the implementation of new systems.
• Prepared weekly sales reports for the sales team and sales management.
• Generated repeat business through successful client follow-up.

Career medium 03

John Dewey College

Medical Insurance Specialist/Medical Biller

John Dewey College

Degree, Medical Billing and Coding

Customer Services Representatives