April Dixon
Raeford,NC
Summary
Seeking a Patient Services Representative role, bringing 19 years of experience in healthcare customer service and finance management. Skilled in resolving patient inquiries, ensuring privacy, and collaborating with teams to enhance patient satisfaction. Proven track record in processing healthcare transactions with high accuracy and efficiency.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Billing Enrolling Representative
Humana Government Incorporated
10.2021 - Current
- Process member enrollments, payments, and address updates, while maintaining strict adherence to performance metrics and attendance standards
- Educate members on Tricare program benefits, offering tailored solutions to meet individual enrollment requirements
- Resolve conflicts, process refunds, and manage account reinstatements, handling over 50 daily communications through calls, emails, and chat
- Achieve a 99% accuracy rate in customer transactions and contribute to a 10% reduction in response time for customer inquiries by implementing efficient response templates.
Adjudicator Customer Service Representative
Alorica
02.2021 - 09.2021
- Resolved benefit eligibility disputes in accordance with State and Federal Unemployment Insurance laws, ensuring precise documentation for transparency and compliance
- Conducted analysis of labor market data and executed comprehensive fact-finding to inform and apply legal and policy frameworks to eligibility determinations
- Issued detailed initial determination reports, clearly communicating decisions and rationales to support the integrity of the Unemployment Insurance program and facilitate informed appeals.
Finance Office Manager
National Finance Company
11.2004 - 12.2020
- Managed credit application procedures, verifying credit histories, and making approval decisions based on predefined criteria
- Executed collections for accounts 30-60 days past due, utilizing skip tracing to locate and engage delinquent account holders
- Supervised daily financial tasks, including deposit handling and allocation of customer payments
- Coordinated administrative duties, including bookkeeping, payroll, inventory management, and office equipment upkeep, while fostering customer service excellence.
Education
Associate Degree, Criminal Justice Technology -
Sandhills Community College
Pinehurst, North Carolina05.2007
High School Diploma -
Hoke County High School
Raeford, North Carolina06.1989
Skills
- Accounts Payable/Receivable
- Microsoft & Excel Documents
- Professional Telephone Etiquette
- Criminal Law Procedures
- Outbound Calling
- Flexibility/Adaptability
- Communication Skill (Written and Verbal)
- Attention to Detail and Accuracy
- Report & Documentation Preparation
- Bookkeeping & Payroll
- Internet Knowledge
- High-Volume Incoming Calls
- Active Listening
- Chat and Messaging Support
- Multitasking and Time Management
- Problem Solving and Troubleshooting
- Technical and Computer Skills
- Data Entry and Management
- Records Management
- Remote Call Center Agent
- Basic Office Equipment
- Multi-Phone Line Experience
- Typing Skills
- Customer Service
- Conflict Resolution
- Empathy and Customer Service Orientation
- Time Management
- Organizational Skills
- Communication
- Problem-solving
- Computer Applications
Certification
- Procedure Coding: Using the ICD-10-PCS, Center for Medicare & Medicaid Service
- Medicare Part C & Part D Reporting Requirements & Data Validation, Center for Medicare & Medicaid Service
- Diagnosis Coding: Using the ICD-10-CM, Center for Medicare & Medicaid Service
- Nice Quality Central System
Timeline
Billing Enrolling Representative
Humana Government Incorporated
10.2021 - Current
Adjudicator Customer Service Representative
Alorica
02.2021 - 09.2021
Finance Office Manager
National Finance Company
11.2004 - 12.2020
Associate Degree, Criminal Justice Technology -
Sandhills Community College
High School Diploma -
Hoke County High School
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