Celestine Downs
Louisville
Summary
Insurance professional with robust experience in claims management and follow-up procedures. Known for improving process efficiency and achieving resolution in complex cases. Reliable team player with focus on collaboration and adaptability, equipped with strong analytical and organizational skills. Experience with Scheduling and Referrals also.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Insurance Follow-Up Representative
Saint Joseph Hospital
Lexington, KY
02.2026 - Current
- Managed insurance claim follow-ups to ensure timely resolution and payment processing.
- Collaborated with healthcare providers to verify patient information and coverage details.
- Utilized billing software for tracking claims status and identifying discrepancies.
- Reviewed denied claims, prepared appeals, and communicated with insurance representatives effectively.
- Streamlined processes for claim submissions, reducing turnaround time for approvals.
Front Desk Representative
Saint Joseph Hospital
Lexington, KY
07.2024 - 02.2026
- Greeted and assisted patients, ensuring a welcoming environment for all visitors.
- Managed appointment scheduling, optimizing patient flow and reducing wait times.
- Processed patient admissions and registrations with accuracy and attention to detail.
- Coordinated communication between departments to facilitate efficient care delivery.
Surgery Scheduler
Baptist Health System KY & IN
Lexington, KY
04.2024 - 07.2024
- Schedule surgeries/procedures for a busy outpatient ambulatory surgery center.
- Collaborated with multidisciplinary teams to streamline communication and enhance patient experience.
- Managed pre-operative documentation, ensuring accuracy and compliance with healthcare regulations.
Surgery Scheduler Coordinator
Saint Joseph Hospital
Lexington, KY
01.2024 - 04.2024
- Schedule surgery for Cardiology
- Communication with Reps
- Consult with cardiologists
Appointment Scheduler
Saint Joseph Hospital
Lexington-Fayette, KY
02.2023 - 01.2024
- Schedule appointments
- Check In walk in patients
- Work Insurance Queues
Medical Biller
Solaris Diagnostics
Nicholasville, KY
07.2022 - 12.2023
- Verify insurance
- Bill Medical insurance claims
- Resolve provider issues
Claims Auditor
Correct Care INTEGRATED HEALTH
Lexington, KY
05.2017 - 07.2022
- Audit processed claims for payment
- Conducted thorough audits of claims to ensure compliance with regulatory standards.
- Reviewed documentation for accuracy and completeness, identifying discrepancies in claim submissions.
- Collaborated with cross-functional teams to develop process improvements for claims handling.
Claims Auditor
Conduent
Lexington, KY
04.2011 - 02.2017
- Audited processed claims.
- Processed Medical Insurance claims
Education
Certificate - Medical Billing And Coding
Spencerian College-Lexington
Lexington, KY05-2018
High school diploma or GED -
Skills
- Auditing
- Microsoft Office
- Medical Coding
- Medical Billing
- Medical office experience
- Typing
- CPT Coding
- ICD-9
- Medical Records
- Insurance verification
- ICD coding
- Anatomy knowledge
- Physiology knowledge
- Phone etiquette
- Documentation review
- HIPAA
- Medical terminology
- ICD-10
- Epic
- Data Entry
- Medical Scheduling
- EMR Systems
- Hospital Experience
- Triage
- Clerical Experience
- Customer service
- Medical records
- Cash handling
- Windows
- Hospital experience
- Computer skills
- Medicare
- Microsoft Excel
- Medical billing
- EMR systems
- Front desk
Certification
Medical Coding Certification
Assessments
- Supervisory skills: Motivating & assessing employees — Proficient
- November 2022
- Motivating others to achieve objectives and identifying improvements or corrective actions
- Full results: Proficient
- Spreadsheets with Microsoft Excel — Proficient
- September 2021
- Knowledge of various Microsoft Excel features, functions, and formulas
- Written communication — Proficient
- Best practices for writing, including grammar, style, clarity, and brevity
- Working with MS Word documents — Completed
- Knowledge of various Microsoft Word features, functions, and techniques
- Full results: Completed
- Administrative assistant/receptionist — Proficient
- April 2022
- Using basic scheduling and organizational skills in an office setting
- Medical terminology — Proficient
- June 2021
- Understanding and using medical terminology
- Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
Timeline
Insurance Follow-Up Representative
Saint Joseph Hospital
02.2026 - Current
Front Desk Representative
Saint Joseph Hospital
07.2024 - 02.2026
Surgery Scheduler
Baptist Health System KY & IN
04.2024 - 07.2024
Surgery Scheduler Coordinator
Saint Joseph Hospital
01.2024 - 04.2024
Appointment Scheduler
Saint Joseph Hospital
02.2023 - 01.2024
Medical Biller
Solaris Diagnostics
07.2022 - 12.2023
Claims Auditor
Correct Care INTEGRATED HEALTH
05.2017 - 07.2022
Claims Auditor
Conduent
04.2011 - 02.2017
Certificate - Medical Billing And Coding
Spencerian College-Lexington