Cynthia Prosser
Simms,TX
Summary
It is my desire to obtain a career in medical world that would utilize my experience to provide excellent patient and customer care. I am a very dedicated and conscientious worker, so I desire to be a part of a team that will allow advancement and growth. My previous work and customer service experience is varied, and I am proficient in Word, Excel, Microsoft Office, Athena, Quick Books and many additional operating programs. Typing is 45-50 WPM, 10-Key by touch. Focused customer service professional dedicated to meeting and exceeding customer expectations by delivering industry-leading support. Skilled in handling inbound and outbound calls, online requests and emails with good problem-solving, multitasking and research abilities. Background in Medical and Customer Service roles with high-volume customer demands.
Overview
8
8
years of professional experience
Work History
Customer Care Professional
Long Term Care Group
Minneapolis, MN
10.2021 - Current
- Explain benefits to policyholders who call in regarding their long-term care policies
- Provide claim status, benefit reimbursement updates, and advise of missing requirements for claims
- Complete outbound calls when needed
- Schedule callbacks from Care Managers to Policyholders when needed
- Utilize multiple company database programs for accessing member information
- Review EOBs
- Document all call information and enter data accurately and timely
- Research required information using available resources
- Maintain the confidentiality of members by following HIPPA guidelines.
Scheduling and Reception
Texarkana Obstetrics and Gynecology
Texarkana, TX
09.2019 - Current
- Responsibilities are Scheduling patients' appointments, verifying insurance, obtaining Primary Care Referrals as well as Pre-Authorizations
- Answering six busy phone lines
- Verification of all patient's demographic information and coordination of care
- Also required obtaining Medical Records for appointments for each new patient
- Receiving Transfer Medical Records submitting them to 6 Providers for approval and scheduling as well
- Processing credit card and debit card payments in addition to balancing daily payments
- Coordinating care for patients Primary Care Referrals
- Verification on various websites from Ahin, Availity, Tricare, Medicare, and others
- Performing Pregnancy test and coordinating with Med Data Medicaid office to aid patients in obtaining Medicaid for Coverage.
Patient Advocate-Remote
Zion Revenue Solutions
Texarkana, TX
04.2018 - 07.2019
- Answer all incoming calls for a Hospital in Colorado for an extended billing office
- Receive patient data for demographic and insurance billing
- Understand medical billing procedures and account aging
- Resolve billing and insurance questions and issues
- Review CPT and Diagnosis codes with patients and review chart notes
- Add Primary, Secondary and Tertiary Insurance to patient accounts
- Review Physician and Facility Claims
- Address and resolve patient billing problems or concerns regarding co-pay, co-insurance, and deductible balances
- Contact patients to update coordination of benefits
- Coordinating calls with both patient and Insurance on three-way calls
- Obtain Workers Compensation information from patients, employers, or adjusters
- Obtain Motor Vehicle Accident reports and information for billing Motor Vehicle Insurance companies from patients or adjusters
- Assist in faxing or emailing UB04's, 1500's or Patient Statements to Insurance or Adjusters
- Accept and process credit card processing
- Set up terms or reoccurring payments for patients
- Function as internal and external resource for patient programs available
- Work with collection agencies to ensure that they receive updated information on accounts, as necessary
- Perform reconciliation of refund accounts attach documentation and forward it to supervisor to process refund checks
- Complete monthly spreadsheet of all incoming credit card and Electronic Fund payments for monthly billing
- Request Medical Record requests for review and Coding when needed.
Insurance Specialist-Remote
Revenue Simplified
Texarkana, TX
10.2015 - 07.2017
- Receive patient data for demographic and insurance billing
- Understand medical billing procedures and account aging
- Resolve billing and insurance questions and issues
- Review CPT and Diagnosis codes with patients and review chart notes
- Add Primary, Secondary and Tertiary Insurance to patient accounts
- Review Physician and Facility Claims
- Address and resolve patient billing problems or concerns regarding co-pay, co-insurance, and deductible balances
- Contact patients to update coordination of benefits
- Coordinating calls with both patient and Insurance on three-way calls
- Obtain Workers Compensation information from patients, employers, or adjusters
- Obtain Motor Vehicle Accident reports and information for billing Motor Vehicle Insurance companies from patients or adjusters
- Assist in faxing or emailing UB04's, 1500's or Patient Statements to Insurance or Adjusters
- Accept and process credit card processing
- Set up terms or reoccurring payments for patients
- Function as internal and external resource for patient programs available
- Work with collection agencies to ensure that they receive updated information on accounts, as necessary
- Perform reconciliation of refund accounts attach documentation and forward it to supervisor to process refund checks
- Complete monthly spreadsheet of all incoming credit card and Electronic Fund payments for monthly billing
- Request Medical Record requests for review and Coding when needed.
Education
High school diploma - Basics
Pinellas Park High School
05.1984
Skills
- 10 Key Data Entry
- Document Management
- Medical Billing
- Medical Records
- Primary Care Experience
- Workers' Compensation
- Microsoft Office (10 years)
- Medical Scheduling
- Insurance Verification
- EMR Systems
- Accounting
- QuickBooks
- Leadership
- Microsoft Excel
- Computer literacy
- Salesforce
- Microsoft Word
- Athenahealth
- Medical Terminology
- Loan processing
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Customer Care Professional
Long Term Care Group
10.2021 - Current
Scheduling and Reception
Texarkana Obstetrics and Gynecology
09.2019 - Current
Patient Advocate-Remote
Zion Revenue Solutions
04.2018 - 07.2019
Insurance Specialist-Remote
Revenue Simplified
10.2015 - 07.2017
High school diploma - Basics
Pinellas Park High School
Personal Information
Work Permit: Authorized to work in the US for any employer
Personal Information
Work Permit: Authorized to work in the US for any employer
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