Summary
Overview
Work History
Education
Skills
Timeline
Generic

Cathy Miller

Indianola,IA

Summary

Provides seamless customer service to providers and patients. Excellent communication, relationship-building and problem-solving abilities. Diligent, attentive and quality-driven. Versatile and committed to maintaining high customer satisfaction by providing friendly, fast service for all needs. Skillful in researching and resolving billing discrepancies and claims. Disciplined and energetic professional well-versed in claim appeal processing, clinical relations and medical/dental billing. Knowledgeable Provider Relations Representative offering years of experience in field. Successfully optimizes services, resolves billing inquiries and reviews data quality. Seasoned Provider Relations Representative possessing in-depth knowledge of various insurance plans and policies. Expertise in handling high volume of calls, efficiently resolving disputes and identifying ways to improve processes. Communicative and detail-oriented individual with excellent interpersonal abilities. Capable Patient Representative dedicated to providing superior support for patients in need of reliable information regarding insurance coverage, finance options and documentation requirements. Well-versed in scheduling and database management functions for streamlined communication and reduced correspondence backlogs. Excels at identifying client needs and concerns to improve engagement strategies and overall service. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.

Overview

24
24
years of professional experience

Work History

External Provider Relations Representative

MCNA
07.2020 - Current
  • Assisted with physician recruitment by identifying specific providers within designated territories, negotiating rates for new physicians and distributing provider agreements.
  • Developed, reviewed and prepared provider education material, increasing efficiencies in processes.
  • Researched and resolved disputes, billing discrepancies and claims efficiently to maintain customer satisfaction, boosting satisfaction ratings.
  • Initiated physician orientations to support ongoing education of health care provider community.
  • Answered provider inquiries via email, telephone and written correspondence.
  • Increased provider satisfaction scores by collecting and credentialing demographic updates, investigating claims and inquiries and overseeing network integrity.
  • Managed provider relations mailbox by triaging inquiries, facilitating resolution of incoming requests and forwarding requests to appropriate parties.
  • Identified network gaps and collaborated with recruiters to fill deficiencies.
  • Fostered strong, positive relationships with key providers by coordinating, facilitating and leading partnership meetings and identifying on-site enrollment opportunities.
  • Provided excellent customer service to patients and dental staff.
  • Facilitated communication between patients and various departments and staff.
  • Resolved customer complaints using established follow-up procedures.
  • Worked with patients to ascertain issues and make referrals to appropriate specialists.

Medical Billing Specialist

Mercy Clinics Inc.
02.2018 - 06.2020
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Located errors and promptly refiled rejected claims.
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Identified and resolved patient billing and payment issues.
  • Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
  • Collected payments and applied to patient accounts.
  • Precisely evaluated and verified benefits and eligibility.
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Filed and updated patient information and medical records.
  • Prepared billing correspondence and maintained database to organize billing information.
  • Communicated effectively and extensively with other departments to resolve claims issues.
  • Liaised between patients, insurance companies, and billing office.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.

Receptionist/Scheduler/Phone Operator

Mercy Clinics Inc
10.1999 - 06.2020
  • Responded to customer inquiries with patience and positivity to establish excellent first impression.
  • Pleasantly greeted all callers and asked how to be of assistance.
  • Managed multi-line phone system directing individuals to desired personnel and providing general information about operations.
  • Answered phones calls daily and directed to appropriate departments and personnel.
  • Collected and verified telephone numbers, addresses, and proper spelling of names.
  • Used company's paging system to immediately contact specific personnel.
  • Scheduled and confirmed appointments for both company personnel and visitors.
  • Resolved customer issues and complaints promptly and politely, upholding satisfaction.
  • Monitored call queues and worked quickly to answer and resolve inquiries within target timeframes.
  • Connected callers with appropriate professional, department, or business.
  • Directed incoming calls to internal personnel and departments, routing to best-qualified department.
  • Supported customers by managing all calls efficiently while maintaining professionalism and upbeat tone.
  • Assisted colleagues with achieving task requirements, aiding team productivity and performance.
  • Processed customer payments for timely, accurate order fulfillment.
  • Operated switchboard and routed incoming calls to appropriate departments.
  • Solved customer inquiries regarding products, orders and account balances quickly to meet service targets.
  • Followed up on customer inquiries to confirm issues were adequately addressed.
  • Identified service improvement opportunities through call volume and performance reports.

Education

High School Diploma -

Southeast Warren Jr-Sr High School
Liberty Center, IA
05.1996

Skills

  • Account Development and Networking
  • Organization and Time Management
  • Benefits Explanations
  • Forms and Spreadsheet Creation
  • Customer Needs Assessments
  • Comfort with Technology and Databases
  • Claims Reviewing
  • Claims Handling and Coverage Verification
  • Provider Support
  • Educational Presentations
  • Multi-Line Telephone Systems
  • Dispute Resolution
  • On-Site Visits
  • Insurance Verification
  • Conflict Management
  • Staff Training
  • Collection Management
  • Interpreting Physician Orders
  • Billing Issue Resolution and Support
  • Reliability and Dedication
  • Appointment Confirmation
  • Provider Orientations
  • Scheduling Medical Appointments
  • Vital Statistics Documentation
  • Outbound Calling
  • Reviewing Data Quality
  • Medical Filing
  • Billing Discrepancy
  • Word Processing
  • Provider Relations
  • Clerical and Filing Support
  • Professional Bedside Manner
  • Curriculum Development
  • General Housekeeping

Timeline

External Provider Relations Representative

MCNA
07.2020 - Current

Medical Billing Specialist

Mercy Clinics Inc.
02.2018 - 06.2020

Receptionist/Scheduler/Phone Operator

Mercy Clinics Inc
10.1999 - 06.2020

High School Diploma -

Southeast Warren Jr-Sr High School

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Cathy Miller