Amy Hester

Claims processing and analysis

• Handle inbound and outbound telephone calls.
• Adhered to HIPAA law and Blue Cross Blue Shield Michigan procedures and policies.
• Provided outstanding customer service to the patients and providers.
• Exhibited emotional intelligence, empathy, and patience.
• Utilized Finesse and Encompass Medical Management Software.
• Microsoft office: Word, and Teams; received/draft letters, chat and attended virtual meetings.
• Verify the patients’ demographics and healthcare plans via Finesse and Encompass.
• Insurance verification: confirmed the coverage and eligibility.
• EOB’s (Explanation of Benefits): reviewed premiums, deductible, and copayments.
• Processed data concerning denied/rejected claims for evaluation and resolution.
• Referred disputed claims to SCIP for further review and adjustment.

• Ensured household duties were completed in a timely manner and managed household budget.
• Coordinated medical care, meals, and social activities.
• Remained deadline-oriented and reliable while adjusting priorities and managing time wisely.

• Serve as direct point of contact and deliver excellent customer service with a positive attitude.
• Operate cash register, scan merchandise, accept payments, ensure accuracy of cash drawer, unload trucks, and keep work area clean and organized.
• Work as part of a team and interact with diverse customers and staff members.

• Welcomed and took temperatures of visitors and employees and checked badges.
• Followed COVID-19 guidelines relating to infection prevention and facility directions to screen for symptoms.
• Followed safety rules and procedures, and ensured personal protective equipment was in use during screenings.

• Communicated effectively via inbound and outbound calls, responded to inquiries, issued quotes, prepared invoices, accepted and processed payments, and kept accurate and complete financial records.
• Performed a full range of janitorial assignments using good judgment and time management.
• Followed established procedures, methods, and practices to meet deadlines.
• Ensured quality control by inspecting work in progress and upon completion.

• Assisted dentists in the direct provision of diagnostic, preventable, general, orthodontic, endodontic, surgical, and periodontic procedures.
• Made sure patient was ready for examination, sterilized and disinfected instruments, set up instrument trays, prepared materials, and exposed dental diagnostic X-Ray images.
• Documented treatment information in patient records, took vital signs, and gathered medical and dental histories and purpose of visit.
• Scheduled appointments, entered data, uploaded X-Rays and treatment plans, and documented inventory needs.
• Abided by HIPAA guidelines to protect private and confidential information.