Dynamic Senior Patient Service Representative with extensive experience at Southern Orthocare, excelling in billing and customer service. Proven ability to resolve complex billing issues and enhance patient satisfaction through effective communication and financial counseling. Proficient in electronic claims submission and committed to maintaining HIPAA compliance while fostering a welcoming environment.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Senior Patient Service Representative and Senior Billing Specialist
Southern Orthocare
Morristown/Greeneville/Remote, TN
08.2023 - Current
Greet patients at check-in and check-out to ensure a welcoming environment.
Direct incoming phone calls to assist patients with inquiries and take messages as needed.
Receive payments, issue accurate receipts, and post patient payments in billing system.
Schedule patient appointments to optimize clinic operations.
Sort faxes and manage medical records for efficient information retrieval.
Process referrals from other offices, and handle prior authorizations effectively.
Assist patients with billing inquiries, insurance details, and financial assistance options.
Submit medical claims to primary, secondary, and tertiary insurers following regulatory guidelines.
Greeted patients, collected personal and insurance information, verified insurance coverage and obtained authorizations for services.
Ensured HIPAA compliance throughout all interactions with patients and their families.
Provided excellent customer service to ensure a positive experience for all customers.
Performed quality assurance checks on data entry into the Electronic Health Record system.
Assisted in training new hires on policies and procedures related to patient service processes.
Escalated complex customer service issues to the appropriate personnel in a timely manner.
Assisted in resolving billing issues including researching accounts, preparing refunds or adjustments as needed.
Processed payments for services rendered by completing credit card authorization forms and accurately documented all financial transactions.
Monitored department performance metrics to identify areas of improvement and recommend solutions.
Communicated effectively with other healthcare professionals regarding patient care needs or concerns.
Collaborated with insurance companies to resolve billing discrepancies and pre-certification issues.
Conducted financial counseling for patients, explaining payment options and assistance programs.
Counselled patients on potential financial liabilities and payment requirements.
Reviewed engine assigned codes and modifiers to update and verify accuracy.
Identified professional development opportunities and delivered comprehensive, standardized and hands-on training to new staff.
Created receiving reports and updated vendor balance sheets to record accounts payable.
Prepared and posted weekly payments to vendors and suppliers.
Verified accuracy of information and resolved discrepancies with vendors before entering invoices for payment.
Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.
Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
Monitored past due accounts and pursued collections on outstanding invoices.
Processed invoice payments and recorded information in account database.
Answered customer questions to maintain high satisfaction levels.
Verified accuracy and integrity of motor vehicle and workers' compensation claims through careful research and analysis.
Weighed envelopes containing statements to determine correct postage and affix postage.
Computed credit terms, discounts and shipment charges for goods or services to complete billing documents.
Enforced compliance with organizational policies and federal requirements regarding confidentiality.
Provided prompt and accurate services through knowledge of government regulations, health benefits and healthcare terminology.
Eliminated inaccuracies in accounts payable payments by verifying information prior to generating checks and electronic payment transfers.
Participated in workshops, seminars, and training classes to gain stronger education in industry updates and federal regulations.
Expedited payments by verifying accuracy and currency of vendor information.
Checked claims coding for accuracy with ICD-10 standards.
Customer Accounts Specialist
Ensemble Health Partners
Remote Midway, TN
04.2023 - 08.2023
Directed incoming calls to assist patients, providing information and taking messages as needed.
Managed customer inquiries through phone and email communication.
Collaborated with healthcare providers to resolve patient account issues.
Educated clients on billing processes and financial responsibility policies.
Analyzed customer feedback to improve service delivery and satisfaction.
Supported training initiatives for new team members on system usage.
Adhered to company policies when handling confidential client information.
Developed strategies to improve customer satisfaction levels.
Maintained accurate records of customer accounts using CRM software.
Maintained up-to-date records of customer interactions, transactions and changes in account status.
Monitored daily workflow to ensure that all tasks were completed on time.
Investigated customer inquiries and disputes promptly and accurately.
Reviewed financial status and evaluated discrepancies by assessing account information and activities.
Ensured accuracy in payment processing and issued appropriate receipts.
Prioritized communication by fostering a people-first approach in all interactions.
Conducted outbound calls to inform patients about account status updates.
De-escalated patient concerns with prompt and appropriate responses.
Facilitated account reviews by coordinating with other departments.
Achieved metrics set by leadership through diligent performance tracking.
Conducted thorough research on accounts, reviewing EOBs from patient insurance.
Patient Service Representative
Southern Orthocare
Morristown, TN
01.2021 - 12.2022
Directed patient inquiries by answering phones and providing assistance or taking messages as needed.
Managed patient appointment scheduling and confirmed follow-up visits.
Assisted patients with insurance verification and financial inquiries.
Coordinated communication between medical staff and patients for clarity.
Handled patient records with confidentiality and compliance standards.
Provided front desk support, greeting patients warmly upon arrival.
Educated patients on office policies and procedures effectively.
Resolved patient concerns through active listening and problem-solving skills.
Maintained organized files for efficient retrieval of patient information.
Scheduled patient appointments to streamline clinic operations.
Sorted faxes and managed medical records for efficient information retrieval.
Processed referrals from external offices and handled pre-authorizations.
Assisted patients with billing inquiries, reviewing charges, policies, and various insurance plans.
Receptionist/Scheduling
Internal Medicine & Family Practice
Greeneville, TN
07.2018 - 12.2020
Assisted patients with billing inquiries and explained charges and insurance policies.
Answered incoming calls, took messages, and transferred calls to appropriate departments or personnel.
Maintained a neat reception area by organizing materials and tidying up furniture.
Performed data entry tasks into various computer systems accurately and promptly.
Provided administrative support to staff members including typing letters, filing documents, and scanning and copying documents when necessary.
Maintained daily calendars, set appointments with clients and planned daily office events.
Processed payments and updated accounts to reflect balance changes.
Delivered administrative support to team members by making copies, sending faxes, organizing documents and rearranging schedules.
Ensured cleanliness and organization of the reception area to maintain a professional atmosphere.
Participated in emergency response drills and maintained knowledge of safety procedures.
Managed patient appointment scheduling to optimize clinic workflow.
Directed phone inquiries, providing information and taking messages as needed.
Sorted medical records and handled fax correspondence efficiently.
Coordinated with hospitals and offices to fulfill doctor orders promptly.
Processed payments and issued accurate receipts, prioritizing precision in transactions.
Insurance Billing Representative
Laughlin Memorial Hospital
Greeneville, TN
01.2016 - 01.2018
Monitored insurance claims to ensure equitable settlement for clients and insurers.
Processed insurance claims accurately and efficiently for hospital services.
Interpreted Explanation of Benefits documents from various insurers.
Responded promptly to customer inquiries related to billing matters.
Prepared financial statements detailing revenue collected from various sources such as private payers, Medicare, Medicaid.
Resolved discrepancies between charges on invoices and those billed to the insurance company.
Managed all payments processing, invoicing and collections tasks.
Identified trends in denied claims and worked with staff members to develop corrective action plans.
Collected, posted and managed patient account payments.
Monitored past due accounts and pursued collections on outstanding invoices.
Assisted clients with problem-solving regarding claims and coverage issues.
Operated telephone switchboard, greeting customers and addressing inquiries.
Contacted insurance companies to verify claim status and facilitate payment follow-up.
Environmental Services
Laughlin Memorial Hospital
Greeneville, TN
01.2014 - 01.2016
Organized supplies, materials, and equipment for optimal access and utilization during shifts.
Ensured that all equipment used by the Environmental Services team was maintained in a safe condition.
Supervised personnel assigned to various projects related to environmental services operations.
Assisted in developing and implementing a comprehensive training program for new Environmental Services staff.
Complied with OSHA standards related to environmental services operations.
Oversaw the daily operations of the environmental services staff.
Coordinated activities between various departments such as engineering, maintenance, security, related to environmental services tasks.
Ensured cleanliness of doctor’s offices to maintain a sanitized environment.
Environmental Services
Laughlin Healthcare Center
Greeneville, TN
01.2012 - 01.2013
Greeted individuals upon entry to enhance customer service experience.
Complied with OSHA standards related to environmental services operations.
Monitored and evaluated the performance of Environmental Services personnel, providing guidance to ensure quality standards were met.
Ensured proper record keeping for all documents pertaining to environmental services activities.
Performed daily assessments of Environmental Services staff to ensure quality service.
Handled escalated complaints from customers regarding their experience with our services or products.
Escorted new arrivals to scheduled activities, introducing them to medical staff for confidence building.
Addressed and resolved staff complaints professionally to maintain service flow and productivity.
Hostess/Cashier
Ryan’s Restaurant
Morristown, TN
01.2010 - 01.2011
Delivered exceptional customer service by addressing requests for an enjoyable dining experience.
Greeted and seated guests promptly upon arrival.
Provided menus and informed guests of daily specials.
Handled guest inquiries and resolved seating issues effectively.
Maintained cleanliness and organization of the waiting area.
Assisted in training new hostesses on procedures and policies.
Collaborated with kitchen staff to communicate guest needs accurately.
Greeted guests warmly upon arrival, seating them promptly.
Answered phone inquiries to schedule and confirm reservations, record takeout orders and respond to service questions.
Created an enjoyable atmosphere by engaging in friendly conversation with guests.
Managed the waiting list, ensuring that all parties were seated in a timely manner.
Built positive relationships with other front-of-house and kitchen staff.
Maintained a clean and organized dining area.
Demonstrated strong interpersonal skills when interacting with customers.
Assisted in preparing the restaurant for opening and closing shifts.
Performed light cleaning duties, such as wiping down tables or sweeping floors.
Provided excellent customer service by addressing customer needs promptly.
Performed other duties as assigned by management.
Stocked shelves with merchandise when needed.
Directed trash removal and sanitation procedures to keep aisles and register area organized.
Promoted company products and services to identify and fulfill customer needs.
Operated telephone switchboard to answer, screen, and forward calls efficiently.
Processed payments accurately while issuing appropriate receipts.
Education
General Diploma - Graduate
West Greene High School
Mosheim, TN
01.2008
Skills
Customer service and support
Data entry and records organization
Fax, copier, scanning, and printer
Switchboard telephone system
HIPAA compliance
Pre-certifications
Problem solving and time management
Ability to make decisions
Ability to learn all management systems
Analyze billing issues
Billing software - electronic claims submission and electronic remittance advice
Claims processing
Insurance overpayments, refunds
Sufficient in Medicare, CGS, Medicaid, and commercial
Administrative and clerical support
Basic computer skills: 50 to 60 WPM
Cashiering and money handling, deposits
Organization and sanitation
Insurance verification
Billing medical insurance claims, including corrected claims, skilled nursing facilities, hospitals, and worker compensation
Adjust well to diverse work activities, and be able to plan effectively to accomplish tasks within the designated work schedule
Maintain strong interactions by developing constructive and cooperative working relationships with others to create a stronger team effort
Speak well, using clarity in diction to convey information and ideas, so others can understand, minimizing errors in the message
Quick memorization of information, such as words, numbers, pictures, and procedures, to better serve customers
Use original problem-solving techniques to quickly address concerns or issues, resulting in complete resolutions that meet company expectations and customer satisfaction
Clinic certifications and webinars, following all Medicare guidelines and documentation requirements
Computer skills using Microsoft Office (Word, Excel, PowerPoint, OneNote, Outlook), including emailing and internet research
Financial counseling
Appointment management
Electronic health records
Friendly and outgoing
Flexible schedule
Certification
HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION
CERTIFICATE OF COMPLETION
PRESENTED TO Brittni Hurlbut
WHO HAS SUCCESSFULLY COMPLETED THE REQUIREMENTS FOR THE CERTIFIED REVENUE CYCLE REPRESENTATIVE
Fields of Study: Specialized Knowledge 11.5, Behavioral Ethics 0.5, Finance 2.0, Total 14.0
06-05-2023 Date Completed
Timeline
Senior Patient Service Representative and Senior Billing Specialist