ALEXANDRA DAUPHIN
Islip Terrace,NY
Summary
Knowledgeable and dedicated customer service professional with over 5 years experience in the healthcare industry. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses.
Overview
13
13
years of professional experience
Work History
Customer Service Liaison
Northwell Health Physician Partners
04.2022 - Current
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Delivered timely and accurate charge submissions.
- Collected payments and applied to patient accounts.
- Prepared billing statements for patients and verified correct diagnostic coding.
- Audited and corrected billing and posting documents for accuracy.
- Produced and mailed monthly statements to customers and assisted with related requests for information and clarification.
- Verified insurance of patients to determine eligibility.
- Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
- Liaised between patients, insurance companies, and billing office.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Communicated with insurance providers to resolve denied claims and resubmitted.
Practice Secretarial Associate
Urogynecology Bayshore/ Northwell Health
01.2021 - 04.2022
- Completed administrative patient intakes with case histories, insurance information, and mandated forms.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Obtained payments from patients and scanned identification and insurance cards.
- Carried out front office duties utilizing data entry skills in the framework of themedical database.
- Received, recorded, and addressed incoming and outgoing communication via telephone and email.
- Answered phone calls and messages for a 5-physician Uro-gynecology medical facility, scheduling appointments and handling patient inquiries.
- Registered and verified patient records before triage with the most up-to-date information.
Clinical Care Coordinator
UnitedHealth Group
02.2019 - 09.2019
- Responded to Incoming Provider and Enrollee calls
- Provided high quality Customer Service to both Providers and Enrollees Forward-thinking and dynamic
- Constantly met established productivity, schedule adherence, exceptional customer service
- Received prior authorizations requests non - clinical assessment / and human resources skills in a intervention and provides appropriate triage professional environment
- Processed out of network requests for consideration of in network level of benefits Languages
- Processed notification requirements for outpatient procedures, home health, DME, transition of care, and network gap issues
- Determined benefit coverage issues
- Set up / documents / triages cases for clinical or medical director review
- Verified appropriate ICD - 10 and CPT coding usage
Patient Account Specialist
Optum 360
03.2016 - 02.2019
- Responded to patient, family, and external payer inquiries
- Accurately interpreted EOBs to patients
- Proficient in GECB, Eagle, Envision Billing system
- Proficient in the HP24 Payment system
- Analyze, identify trends, and provide reports as necessary
- Monitored flags and resolved urgent items with accuracy and efficiency
- Handled a high volume of inbound calls pertaining to the reconciliation of delinquent accounts
- Managed subrogation files
- Contacted clients with past-due accounts to formulate payment plans and discuss restructuring options
- Answered constant flow of customer calls with up to 50 calls in queue per minute
- Ensured adherence to state and federal compliance policies, reimbursement policies and contract compliance
- Worked with outside entities to resolve issues with billing, claims and payments.
- Provided claims expertise support by reviewing, researching, investigating, and resolving all types of claims as well as recovery and resolution for health plans
- Worked with outside entities to resolve issues with billing, claims and payments
Customer Service Representative
P.C. Richard & Son
06.2010 - 12.2014
- Met established productivity goals and quality standards
- In bound -Customer, Service Representative Effectively handled and responded to all customer complaints and inquiries, acquiring all appropriate and necessary information
- Provided exceptional customer service to all clients via phone, electronic correspondence, and in-person
- Followed up with all customer interactions
- Provided primary customer support to internal and external customers in fast-paced environment
Education
Bachelor of Science - Scinece, Technology & Society
SUNY Farmingdale
Farmingdale, NY05.2022
Skills
- Case management
- Conflict resolution
- Documentation and control
- Database Administration
- Regulatory compliance
- Computer proficient
- MS Office proficiency
- Medical terminology knowledge
- GECB
- Sorian
- Healthpay24
- Service standard compliance
- Administrative support
- Complaint resolution
- Professional telephone demeanor
- Multi-line phone talent
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
The person who says it cannot be done should not interrupt the person who is doing it.
Chinese proverb
Timeline
Customer Service Liaison
Northwell Health Physician Partners
04.2022 - Current
Practice Secretarial Associate
Urogynecology Bayshore/ Northwell Health
01.2021 - 04.2022
Clinical Care Coordinator
UnitedHealth Group
02.2019 - 09.2019
Patient Account Specialist
Optum 360
03.2016 - 02.2019
Customer Service Representative
P.C. Richard & Son
06.2010 - 12.2014
Bachelor of Science - Scinece, Technology & Society
SUNY Farmingdale