Halimo Mohamed
Grapevine,TX
Summary
Customer service-oriented professional with healthcare industry and call center experience. Able to provide timely and accurate data to ensure reimbursement for patient services. Follow policies, procedures, and guidelines to ensure consistent quality. Maintain and assure patient privacy and confidentiality. Academic Honors Recognition / Honor Roll. Ultimate Medical Academy – HIPAA Essentials for Healthcare Professionals Certificate. Strong time management skills with ability to establish priorities to meet timelines. Attention to detail needed to maintain high levels of accuracy. Effective problem solver, able to assess situations and identify solutions. National CPR Foundation – CPR, AED, and First Aid certified. Online Word Processor – Google Docs. Communication Platforms – Zoom. Microsoft Office Applications – Word, Excel, and PowerPoint | Type 36 WPM.
Overview
9
9
years of professional experience
Work History
Utilization Management Representative
First Source
Grapevine, TX
07.2025 - Current
- Conducted thorough reviews of patient care plans to ensure compliance with utilization management guidelines.
- Collaborated with healthcare providers to facilitate timely authorizations and streamline service delivery processes.
- Analyzed patient data to identify trends, ensuring accurate assessments of medical necessity for services rendered.
- Developed training materials for new staff, enhancing understanding of utilization management protocols and systems.
Home Health Aide – PRN
Tender Hands Home Health Services
Columbus, OH
01.2024 - 04.2024
- Assisted with mobility, including transferring clients to and from wheelchairs, beds, and other assistive devices.
- Followed Individualized care plans and ensured compliance with healthcare guidelines and standards.
- Prepare nutritious meals and ensured dietary needs and restrictions were met.
Home Health Aide
Best Choice
Columbus, OH
08.2023 - 01.2024
- Assisted with activities of daily living, mobility exercises, light housekeeping, and meal preparation.
- Administered medications, monitored vital signs, and offered companionship.
- Supported individuals in always maintaining independence and improving overall well-being.
- Respected and safeguarded patient’s privacy.
Customer Service Representative – Remote
ACGN
Grand Forks, ND
08.2021 - 06.2023
- Assisted clients with selling and purchasing homes.
- Conducted Facebook home selling by creating and managing engaging posts and advertisements to attract buyers.
- Documented activity in customer accounts in an accurate manner and ensured confidentiality.
- Identified customer needs, provided resolutions to problems, and followed established procedures.
Customer Service Representative
ACT
Fort, KS
05.2020 - 10.2020
- Maintained a high level of professionalism and courtesy, ensuring a positive customer experience and building rapport with customers.
- Assisted in managing customer accounts, updated contact information, processed payments, and resolved billing discrepancies in a timely manner.
- Effectively communicated complex technical concepts to non-technical customers, enabling them to understand and resolve their issues.
Customer Service Representative
Scarlet Management LLC
Columbus, OH
01.2019 - 02.2020
- Sold and upsold consumer products, person-to-person, to a select customer base.
- Demonstrated product usage, communicated benefits, and answered questions regarding product line.
- Organized and managed client records and accepted payments.
Customer Service Representative – Call Center
Teleperformance
Westerville, OH
09.2017 - 12.2018
- Supported and provided individualized sales and customer service via inbound calls, chats, and emails.
- Provided information necessary to sell and upsell clothing and placed customer order in computer.
- Collected and entered customer information, verified for accuracy, and followed confidentiality policies.
Education
Associate of Science Degree - Medical Billing and Coding
Ultimate Medical Academy
01.2025
Skills
- Medical Terminology
- Anatomy & Physiology
- HIPAA Compliance
- Medical Coding (ICD-10-CM
- HCPCS
- CPT)
- Medical Billing
- Accounts Receivable
- Collections
- Co-Pay
- Deductibles
- Co-Insurance
- EOBs
- Revenue Cycle Management
- Posting Payments
- Government (Medicare & Medicaid)
- Third Party Payers
- Electronic Health Records (EHR)
- Electronic Medical Records (EMR)
- Managed Care (HMO
- PPO
- POS)
- Workers Compensation
- Insurance Verification
- Insurance Claim Processing
- CMS 1500
- CMS 1450 (UB-04)
- Front Office Operations
- Medical Office Procedures
- Scheduling
Timeline
Utilization Management Representative
First Source
07.2025 - Current
Home Health Aide – PRN
Tender Hands Home Health Services
01.2024 - 04.2024
Home Health Aide
Best Choice
08.2023 - 01.2024
Customer Service Representative – Remote
ACGN
08.2021 - 06.2023
Customer Service Representative
ACT
05.2020 - 10.2020
Customer Service Representative
Scarlet Management LLC
01.2019 - 02.2020
Customer Service Representative – Call Center
Teleperformance
09.2017 - 12.2018
Associate of Science Degree - Medical Billing and Coding
Ultimate Medical Academy