ALEXANDRA WALSMLEY
Woonsocket,RI
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised able to multitasking, organizational skills across diverse settings and time management abilities. Devoted to giving every customer a positive and memorable experience and passionate about continuous learning and professional development
Overview
10
10
years of professional experience
Work History
REP I ELECTRONIC MEDICAL RECORDS-SUPER USER
CVS/CORAM
WOONSOCKET, RI
04.2021 - Current
- As part of the Centralized Electronic Medical Records team, we were tasked with indexing incoming faxes from providers and insurers through multiple electronic systems.
- This included triaging based on urgency.
- Identifying document type accurately and electronically alerting proper teams for timely patient service outcomes.
- As a Super User for this team, I was responsible for supervising team workflows and supporting standard users.
- I was also responsible for reporting, tracking, and error correction queues.
- Training
UNBILLED /CLAIMS REPRESENTATIVE
CVS/CORAM
NORWOOD, MA
05.2020 - 03.2021
- Conducted research into medical terminology related to healthcare claims processing activities.
- Ensured timely submission of required documentation from claimants prior to approval of payment.
- Adhered to strict guidelines pertaining to confidentiality while handling sensitive personal information.
- Investigated facts, confirmed coverage and liability, negotiated settlements, and determined payments for claims.
- Processed a high volume of claims efficiently while maintaining quality standards.
- Released suspended claims
Patient Intake Coordinator
cvs/coram
NORWOOD, MA
09.2019 - 03.2020
- Act as the main point of contact for Coram's patients, caregivers, referral sources, and Sales team.
Resolve patient issues and respond to phone and fax inquiries regarding in-home IV order requests.
Assess patient needs and document all communication in the Electronic Medical Records system regarding coordination of care.
Communicate with various departments by providing information pertaining to equipment, supplies, and services needed to start patients on service with our company.
Collaborate with Coram's insurance professionals to verify patient benefit coverage and financial responsibility. Relay insurance coverage and patient responsibility to referral sources, sales, and patients. Discuss patient responsibility and documentation required for billing of services.
Confirm start of care details with all parties to ensure a seamless transition into home care for our customers.
Admissions Representative
CVS/CORAM
NORWOOD, MA
05.2019 - 03.2020
- Sent patient admissions document to sign and return.
- Called patient to obtain insurance information and email address.
- Enter discharge date in system.
- Assisted the Specialty group in contacting doctors' office to obtain recent History & Physicals and Labs for re-certification.
- Indexed documents in the patient's chart.
- Clerical received faxes and distributed.
- Entry of proof of delivery documents.
HSCM
Early Childhood Education Center
MILFORD, MA
02.2019 - 04.2019
- Contact health insurances to verify eligibility for Early Intervention Services coverage.
- Set up client chart and set-up authorization for the services. Add multiple payors if the patient has secondary insurance.
- Performed medical billing and checked to see if the claim was paid, processed correct diagnosis with correct CPT code.
- Contact the physicians to get referrals, if needed.
- Cancel and update charts.
- Set up each patient with coverage from the Department of Health of Massachusetts if the client does not have coverage, as it is a mandated service. Also, receive inquiries from the program to set up clients' charts and update the health insurance.
Customer Service Representative
Medtronics
Attleboro, MA
05.2018 - 09.2018
- Answered customer inquiries and provided accurate information regarding products and services.
- Assisted customers with product selection, ordering, billing, returns, exchanges and technical support.
- Performed administrative tasks such as filing paperwork, updating databases and generating reports.
- Tracked orders from start to finish to ensure timely delivery of goods or services.
NTT DATA-CONTRACT JOB
BLUECROSS OF RHODE ISLAND
East Providence, RI
01.2018 - 05.2018
- Answered provider calls regarding non-payment of claims.
- Provided daily oversight of work performed by contractors, ensuring compliance with all regulations and standards.
Customer Service Call Center Representative
CVScaremark
Lincoln, RI
11.2014 - 05.2016
- Answered incoming customer calls promptly, providing courteous and professional service.
- Assisted customers with product inquiries, orders, and complaints in a timely manner.
- Resolved customer issues by troubleshooting problems over the phone or via email.
- Followed up with customers on open cases as needed to ensure satisfaction was achieved.
- Assist with troubleshooting their online account.
Education
GED -
East Providence High School
East Providence, RI10-1992
Skills
- Medical Receptionist
- Reliability
- Contract negotiation expertise
- Account development
- [Health Insurance] sales techniques
- Business growth and retention
- Performance Metrics
- Adaptability
- Professionalism
- Experience in leadership
- Multitasking
- Problem-solving aptitude
- Audit reporting
- Health insurance claim
- Call center
Affiliations
- Enjoy reading, traveling, camping, decorating
Accomplishments
- have received multiple recognitions for going above and beyond
Languages
Spanish
Professional
References
References available upon request.
Timeline
REP I ELECTRONIC MEDICAL RECORDS-SUPER USER
CVS/CORAM
04.2021 - Current
UNBILLED /CLAIMS REPRESENTATIVE
CVS/CORAM
05.2020 - 03.2021
Patient Intake Coordinator
cvs/coram
09.2019 - 03.2020
Admissions Representative
CVS/CORAM
05.2019 - 03.2020
HSCM
Early Childhood Education Center
02.2019 - 04.2019
Customer Service Representative
Medtronics
05.2018 - 09.2018
NTT DATA-CONTRACT JOB
BLUECROSS OF RHODE ISLAND
01.2018 - 05.2018
Customer Service Call Center Representative
CVScaremark
11.2014 - 05.2016
GED -
East Providence High School