Colleen Walsh
Rehoboth Beach,DE
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, ad providing customized solutions to build loyalty.
Overview
23
23
years of professional experience
Work History
Server
The Wheelhouse
06.2024 - Current
- Demonstrated strong multitasking skills by managing multiple tables simultaneously without compromising service quality.
- Served food and beverages promptly with focused attention to customer needs.
- Worked with POS system to place orders, manage bills, and handle complimentary items.
- Collaborated with team members during busy shifts for efficient workflow and excellent guest experiences.
- Cultivated warm relationships with regular customers.
- Enhanced customer satisfaction by promptly attending to their needs and providing personalized service.
Billing Specialist
Synergy Pharmacy Services, LLC.
10.2023 - 05.2024
- Adjudicate, move, and work daily prescription rejections timely
- Consolidate facility residents' prescriptions monthly and batch submit to third party payers, resolve all denials before prescriptions are delivered on cycle exchange
- Obtain and enter daily censuses including all face sheet demographics, financially responsible payer info and Medicare, Medicaid, or Commercial insurance status
- Process all prospective billing functions daily for assigned facilities
- On biweekly basis, review prebilling reports to identify any discrepancies and reconcile as needed
- Handle all aspects of facility and private billing for assigned facilities monthly
- Work with providers, pharmacy staff, and nursing to notify when prior authorizations are needed and complete prior authorizations in timely manner
- Communicate with all facility clinical and administrative staff professionally, efficiently, and effectively
ER Patient Access Representative
Children's Hospital of Phila
09.2022 - 10.2023
- Welcomes patients/families and guests onto Hospital grounds and assists with needs to enable patients/guests to get to correct destinations
- Perform EPIC functions such as check in, check out, enter demographic and insurance information while ensuring accuracy, run daily eligibility verifications, Collected and entered patient demographic and insurance data into computer database to establish patient's medical record for billing dept
- ED/Admissions specific tasks as assigned include: Nurse Call communications, and EMS arrivals and Direct Admits and Transfers
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy
- Cross trained in multiple departments to help cover staff shortages, lunches, vacation time and callouts
Banquet Server/Bartender
The Orpheus Club of Philadelphia
01.2002 - 05.2023
- Set up for events, arranging table placement and setting up a buffet, Served high customer volumes during special events, nights, and weekends
- Managed multiple tasks simultaneously while maintaining composure under pressure in fast-paced banquet environments
- Perform cleaning tasks and breakdown of service, maintain high standards of safety and cleanliness, adhere to grooming and appearance standards
Server
Sicilian Trattoria
01.2015 - 03.2022
- Arranged and prepared tables for customers to offer memorable experiences to guests and foster repeat business
- Served food and beverages promptly with focused attention to customer needs
- Greet guests in a friendly and courteous manner and explain any specials and/or restaurant promotions for guest awareness
- Worked with POS system to place orders, manage bills, and handle complimentary items
- Helped customers with dietary restrictions, allergies and intolerances obtain safe, delicious food by working closely with kitchen staff on alternatives
LTC Billing Specialist
Contract Pharmacy Services
05.2021 - 12.2021
- Processed insurance claims to ensure accurate billing and reimbursement for long-term care facilities, and behavioral health consumers
- Respond in professional manner to all billing and customer inquiries and processed returned orders, reconcile errors in resident pay statements
- Reconcile Census and demographic information to ensure correct billing for Medicaid, Medicare, and Commercial Insurance billing Perform month end processes in preparation for billing close on long term care assigned facilities
- Assisted patients in accessing financial assistance and other community resources
Patient Care Coordinator
Asembia Pharmacy
06.2020 - 05.2021
- Complete prescription intake process including verification of insurance coverage, Assist physician's offices through the prior authorization and appeals process, Research financial assistance options for patients through copay cards, foundations, and assistance programs
- Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times
- Provided exceptional customer service by addressing concerns, answering questions, and ensuring patient satisfaction with their care experience at the clinic
Customer Service Advocate
Cigna Home Delivery Pharmacy
10.2016 - 04.2020
- Managed high call volume during peak hours, prioritizing urgent cases while maintaining attention to detail
- Receive and answer requests by telephone for prescriptions from CIGNA members, provider's offices, and doctor's offices
- Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly
- Process Specialty Pharmacy orders within established guidelines, while providing detailed documentation via internal and external systems and assistance with external foundations or funding programs for copay relief
- Cross trained in maintenance medications, specialty drugs and insurance benefits
- Built long-term, loyal customer relations by providing top-notch service and detailed order, account, and service information
Education
Certification - Ethics
Great Valley Penn State
Malvern, PA03.2024
Diploma - Medical Office Administration
CHI Institute
Southampton, PA11.2009
Diploma -
Cheltenham High School
Wyncote, PA06.2004
Skills
- Microsoft Office Programs
- Billing Systems
- EMR Software
- Insurance Verification
- Pharmacy Billing
- Claims
- Call Center Environment
- PPO/HMO Policies
- Medicare, Medicaid Policies
- Registration and Admissions
- Long Term Care
- Point Click Care and Census Reports
- HIPPA Compliance
- Medical, Pharmacy and Dental Terminology
- Prior authorizations and Appeals
- Exceptional customer service
- Interpersonal skills
- Verbal and written communication
- Multitasking and Organization
- Strong Work Ethic
Timeline
Server
The Wheelhouse
06.2024 - Current
Billing Specialist
Synergy Pharmacy Services, LLC.
10.2023 - 05.2024
ER Patient Access Representative
Children's Hospital of Phila
09.2022 - 10.2023
LTC Billing Specialist
Contract Pharmacy Services
05.2021 - 12.2021
Patient Care Coordinator
Asembia Pharmacy
06.2020 - 05.2021
Customer Service Advocate
Cigna Home Delivery Pharmacy
10.2016 - 04.2020
Server
Sicilian Trattoria
01.2015 - 03.2022
Banquet Server/Bartender
The Orpheus Club of Philadelphia
01.2002 - 05.2023
Diploma - Medical Office Administration
CHI Institute
Diploma -
Cheltenham High School
Certification - Ethics
Great Valley Penn State
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