Carol Brown
Austin,TX
Summary
Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires and providing customized solutions to build loyalty.
Overview
10
10
years of professional experience
Work History
Customer Service Representative
DSHS Laboratory
Austin
03.2022 - 09.2022
Medical Records/Documents Imaging
St. David's Medical Center
Austin
03.2021 - 09.2022
Contract Specialist IV
PERK PERFORMERS AGENCY/HHSC DADS
AUSTIN
08.2023 - Current
- Prepared monthly reports summarizing the status of contracts under management
- Ensured compliance with contractual terms, conditions, and regulations
- Conducted detailed reviews of contract documents to ensure accuracy and completeness
- HHSC Medicaid Chip Services (MCS) AS Contract Specialist IV work on HIGH PRIORITY ASSIGMENTS
- Reports to the Health Plan Manager located in the Managed Care Contracts and Oversight (MCCO)
- Performed general clerical duties such as photocopying, faxing, mailing and scanning documents
- Maintained files and filing, keeping sensitive information confidential
- Helped managers in other departments with projects as needed
- Created spreadsheets and maintained databases utilizing Microsoft Excel
- Developed and maintained filing systems for confidential documents and records
- Created, maintained and entered information into databases
- Operated electronic mail systems and coordinated flow of information, internally, and with other organizations
- Generated regular reports on project progress utilizing spreadsheet software applications like MS Excel and Access
- Utilized strong organizational skills to prioritize tasks efficiently while meeting deadlines
- Retrieved requested medical records in a timely manner while maintaining confidentiality of protected health information
- H.I.M
- (Health Information Management) Retrieve/Reconcile medical records and loose documentation from ancillary departments, facilities, vendors, etc (ER-Emergency Room, IP-Inpatient Admit in the Hospital, SD-Same Day Procedure/Outpatient Patient Collection
Medical Records/Documents Imaging (PRN)
St. David's Medical Center
Austin, TX
09.2022 - Current
- Self-motivated, with a strong sense of personal responsibility.
- Excellent communication skills, both verbal and written.
- Skilled at working independently and collaboratively in a team environment.
- *H.I.M.(Health Information Management) Document Imaging consist of Handling and Work with various type of Confidentiality and HIPPA (Health Insurance Portability and Accountability ACT).
*Utilized knowledge of HIPAA regulations to ensure privacy and security standards were met for patient records.
*PHI (Protected Health Information). - *Assists Hospital Staff with requests for information on discharged and active.
*Responsible for reporting lost charts and spacing to the Director.
*Protects Patient Health Information Data such as medical histories, diagnoses and symptoms test results. - *Retrieve/Reconcile Medical Records loose documentation from ancillary departments, facilities, vendors, etc (ER-Emergency Room, (IP)-Inpatient Admit in the Hospital, (SD)- Same day Procedure/Outpatient.
- Worked well in a team setting, providing support and guidance.
- Passionate about learning and committed to continual improvement.
- Managed time efficiently in order to complete all tasks within deadlines.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Worked effectively in fast-paced environments.
- Strengthened communication skills through regular interactions with others.
Customer Service Representative II
DSHS Laboratory
Austin
02.2023 - 03.2023
Texas Works Advisor III
Health & Human Services Commission Department
Austin
09.2022 - 01.2023
Insurance Verification/Authorization Department
St. David's Ambulatory Surgery Center
Austin
04.2020 - 08.2021
Patient Collection/Authorization
St. David's Ambulatory Surgery Centers
Austin
04.2018 - 04.2020
Referral Specialist/Authorization
St David's Heart & Vascular
Austin
08.2016 - 04.2018
Registration Specialist/Verification
St David's Heart & Vascular
Austin
11.2015 - 08.2016
H.I.M Tech/Medical Office Specialist
St David's Heart & Vascular
Austin
11.2014 - 11.2015
Education
High School Diploma -
Johston High School
Austin, TX 06.2023 - 07.2023
Skills
Document filing
Payment collection
Medical insurance
Documentation and paperwork
Excellent Communication
Authorizations understanding
Application verification
Retro-Authorizations
EPIC
Authorizations
Insurance authorization
Understanding of insurance details
Claim research
Physician order verification
Benefit Coverage
Insurance coverage verification
Data integrity
Patient contact
Documentation abilities
Understanding of medical terms
Excellent administrative abilities
Prior authorization processing
Data Entry
Organization and Time Management
Clerical Support
Active Listening
Contract performance management
Problem-solving
Teamwork and Collaboration
Self-Motivated
Call center operations
Customer support
Inbound phone calls
Answering questions
Logging call information
Problem-solving skills
Client communication
Performance improvement
Verbal and written communication
Chart pulling
Insurance verifying
Paperwork processing
Filing systems expertise
EMR / EHR
Medical office administration
Medical terminology understanding
Case management
Billing oversight
Medical transcription
Records management
Records review
Written and verbal communication
Contact - Skills
- Excellent Customer Services
- Skills to Healthcare Providers & Recipients
- Insurance Verification
- Administrative Assistant IV
- Medicare & Medicaid Eligibility and Various Health Plan
- Familiar with Obamacare Eligibility and MAP Program
- Outreach Specialist/Enrollment
- Referral/Authorization Specialist
- Medical Records Specialist
- Call Center Representative
- H.I.M (Health Information Management) Department
- Contract Specialist IV
- Enrollment and Eligibility Representative
References
- Christina Davis, Supervisor, (512) 206-3600, Christina.davis@hcahealthcare.com
- Nora Tijerina, Supervisor, (512) 709-1873, nora.tijerina@hcahealthcare.com
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Accomplishments
**One of My Goals was to Work for Texas Health & Human Services
* Texas Advisor or *Eligibility Specialist
*Teenage Parents & *Medicaid Recipients @ the age 15 years
*What H.H.S.C. Medicaid Eligibility Offer *Explain Health Benefits
*I was to Scared to ask questions
* never worked Healthcare Environment *1st job was Dan's Hamburgers
My Goal was to be come TX Advisors or Eligibility Specialist to get the Knowledge & Training & Skills, explains What TX Medicaid Offer Healthcare & Vision & Dental, Medical Transportations.
*What's the different *Checkup & *TX Medical Checkup
*How to verify Healthcare benefits.
Thanks God everything I know working for Temp Job & Agencies & Hands on Training, Remember I was TX Medicaid Recipients, It felt so Good to say I ACHIEVED MY GOALS and I CRIED still looking for New Challenge's.
Timeline
Contract Specialist IV
PERK PERFORMERS AGENCY/HHSC DADS
08.2023 - Current
High School Diploma -
Johston High School
06.2023 - 07.2023
Customer Service Representative II
DSHS Laboratory
02.2023 - 03.2023
Medical Records/Documents Imaging (PRN)
St. David's Medical Center
09.2022 - Current
Texas Works Advisor III
Health & Human Services Commission Department
09.2022 - 01.2023
Customer Service Representative
DSHS Laboratory
03.2022 - 09.2022
Medical Records/Documents Imaging
St. David's Medical Center
03.2021 - 09.2022
Insurance Verification/Authorization Department
St. David's Ambulatory Surgery Center
04.2020 - 08.2021
Patient Collection/Authorization
St. David's Ambulatory Surgery Centers
04.2018 - 04.2020
Referral Specialist/Authorization
St David's Heart & Vascular
08.2016 - 04.2018
Registration Specialist/Verification
St David's Heart & Vascular
11.2015 - 08.2016
H.I.M Tech/Medical Office Specialist
St David's Heart & Vascular
11.2014 - 11.2015