Summary
Overview
Work History
Education
Skills
Timeline
Generic

BETTY RUTHERFORD

Blythewood,SC

Summary

Looking to secure a challenging yet rewarding role that may allow me to use years of experience by providing fast, accurate, and empathetic support to a wide range of customers. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Knowledgeable Case Manager experienced in coordinating care for insured/ non- insured individuals. Proactive and resourceful with strong knowledge of community resources. Strong communicator with passion for helping others. Knowledgeable Case Manager experienced in coordinating care for Medicare, Medicaid and commercial insured individuals. Proactive and resourceful with strong knowledge of community resources. Strong communicator with passion for helping others. Knowledgeable Case Manager experienced in coordinating care for Medicare, Medicaid and Commercial insured individuals. Proactive and resourceful with strong knowledge of community resources. Strong communicator with passion for helping others. Knowledgeable Case Manager experienced in coordinating care for insured individuals. Proactive and resourceful with strong knowledge of community resources. Strong communicator with passion for helping others. Knowledgeable Case Manager experienced in coordinating care for [Type] individuals. Proactive and resourceful with strong knowledge of community resources. Strong communicator with passion for helping others.

Overview

14
14
years of professional experience

Work History

Case Manager

Amerisourcebergen Remote
11.2022 - Current
  • Ability to serve as a liaison between the patients, their families, and healthcare professionals
  • Ability to demonstrate compassion, understanding and empathy
  • Ability to maintain records and client files
  • Knowledge of medical billing and coding
  • Excellent verbal and oral communication skills

Patient Access Specialist

Lashgroup/AmerisourceBergen Remote
11.2020 - 11.2022
  • Provides advanced services to patients, providers and caregivers
  • Services could include but not limited to:
  • Billing and coding support
  • Claims assistance, tracking and submission
  • Prior authorization assistance and tracking
  • Coordination of benefits
  • Welcome calls
  • Advanced alternate coverage research
  • Appeals/Denials
  • Intakes and reports adverse events as directed
  • Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.

Maximus Columbia SC
01.2020 - 11.2020
  • Census Intake
  • Maintained low security clearance and background check
  • Handled inbound and outbound contacts in a courteous, timely, and professional manner
  • Adhered to Census approved scripts and conducted interviews and completed forms
  • Entered data into a desktop application to accurately capture all responses
  • Adhered to the Titled 13 requirements for maintaining confidentiality of all Census data

Customer Care Representative

First Citizens Bank and Trust
01.2018 - 08.2019
  • First call resolution for all retail banking inquiries, commercial inquiries, online banking (Business and Retail), bankcard, fraud, forgery, ID theft, abide by and follow all company policy and procedure.

Medical Claims Specialist

Recruiting Solutions
01.2017 - 01.2018
  • Actively work accounts, rebill claims to carriers, File appeals, read EOBs, practiced knowledge of ICD-9, ICD-10
  • CPT coding, and medical terminology, complete Medicare and Medicaid system claims.

Managed Care Coordinator/Customer Service Rep./Care Specialist

Horizon NJ Health/Aerotek
07.2011 - 08.2015
  • Work multi-phone lines, faxed legal documents and billing statements, maintain HIPAA compliance, prepare, document and route cases for clinical review, initiate callback or correspondence to physicians for case completion, Conduct data entry, assist in conducting report and analysis, all duties assigned by mgmt.

Customer Service Representative

ACS/Nesco Resources
09.2010 - 06.2011
  • Track and log updated information into HW7 system, assist with benefit selection and educate on their new healthcare networks as well as how to connect with providers in network, process and submit updated forms to human resources.

Education

Bachelor's - Criminal Justice

Southern New Hampshire University

Associate Degree - Paralegal Studies

Remington College
Lake Mary, FL

Skills

  • Problem-Solving
  • Case Management
  • Case Documentation
  • Organization and Multitasking
  • Knowledgeable in legal procedures and terminology
  • Exceptional verbal and written communication skills
  • Proficient in medical billing and coding
  • Familiarity with HIPPA regulations and Title 13 requirements
  • Documentation And Reporting
  • Documentation proficiency
  • Data Entry and Analysis
  • Patient support

Timeline

Case Manager

Amerisourcebergen Remote
11.2022 - Current

Patient Access Specialist

Lashgroup/AmerisourceBergen Remote
11.2020 - 11.2022

Maximus Columbia SC
01.2020 - 11.2020

Customer Care Representative

First Citizens Bank and Trust
01.2018 - 08.2019

Medical Claims Specialist

Recruiting Solutions
01.2017 - 01.2018

Managed Care Coordinator/Customer Service Rep./Care Specialist

Horizon NJ Health/Aerotek
07.2011 - 08.2015

Customer Service Representative

ACS/Nesco Resources
09.2010 - 06.2011

Bachelor's - Criminal Justice

Southern New Hampshire University

Associate Degree - Paralegal Studies

Remington College
BETTY RUTHERFORD