Jennifer Tesorero
N. Billerica,MA
Summary
Dedicated Practice & Surgical Assistant with excellent experience and knowledge of the medical insurance industry as well as a wide array of medical office functions. Maintains professional appearance and demeanor while expertly completing assigned tasks with focus on quality. Dependable and quick-learning team player with effective written and verbal communication skills as well as general and managerial organization skills.
Overview
30
30
years of professional experience
Work History
Office assistant II / Surgical Scheduler
Boston Hand to Shoulder
Newton, MA
02.2019 - Current
- Check-in patients
- Verify registration information
- Scan insurance cards
- Take copayment / Balances
- Chart prep
- Send faxes and Emails
- Scan documents into EPIC
- Answer phones
- Schedule appointments (post-op, NP, Follow-up, FX care)
- Check out patients
- Schedule radiology testing (CT’s, MRI’s, Ultrasounds, etc.)
- Scheduling surgical procedures with NWH and HWH OSC
- Obtain W/C approvals and fees to schedule surgical procedures
- Entering post -surgical data into EPIC
- Scheduling surgical equipment
- Complete surgical confirmation calls
- Send surgical email requests for therapy appointments
- Send surgical Emails to patients
- Check the referral work queue and schedule appointments as needed
- Check Televox (Automated call reminder) report and cancel out any patients that canceled through the Televox report
- Call for authorizations of radiology testing and surgical procedures
- Send messages to Physician assistants via EPIC system.
Team Lead Member
Tufts Health Plan Medicare Preferred
Watertown, MA
02.2016 - 06.2018
- Perform weekly side by side coaching sessions with reps to provide timely feedback to representatives
- Respond professionally and promptly to phone inquiries while maintaining the required performance service standards
- Answer incoming phone calls from members and adheres to department customer service expectations
- Ensures issues are accurately and completely resolved by using available resources, including Tufts Health Plan’s information systems and internal contacts in other supporting departments
- Ask probing questions and take the opportunity to educate member and providers to avoid unnecessary repeat calls and delays
- Provide clear and accurate documentation to ensure problem resolution
- Respond to inquiries from other key departments in a timely manner
- Adheres to assigned schedules to ensure appropriate phone coverage
- Serve as a key contributor at department meetings and occasionally lead team meetings
- Mentor new staff
- Work on special projects as required
- Adheres to Tufts Health Plan’s Corporate Compliance policy
- Serves as covering supervisor in supervisor’s absence and seeks solutions to high queue volume, staffing needs and problem resolution
- Responds to escalated calls that require intervention
- Coaches staff in resolving complex member and provider issues
- Present creative suggestions for improving morale, department processes, and workflows to management team
- Serves as an expert with regard to member and claim knowledge and Tufts Health Plan systems
Customer Relations Supervisor
Tufts Health Plan Medicare Preferred
Watertown, MA
04.2012 - 02.2016
- Provide call coaching, constructive feedback and direction to staff to ensure consistent customer service
- Work with staffing operations to identify opportunities to improve efficiency and the attainment of SLA’s
- Develop policies, procedures and guidelines to support consistent delivery of service
- Work with Team Leads to ensure reliable coverage and adequate oversight
- Ensure a positive, collaborative working environment for the team
- Hire, discipline and do annual performance evaluations for all staff
- Creatively solve complex member issues as efficiently as possible by leveraging available systems, researching and reaching out to partner departments as needed
- Provide updates/documentation to clarify difficult or complex issues
- Interacts and forms contacts with other THP staff, particularly with key departments to identify opportunities and develop processes to improve member satisfaction and administrative efficiency
Team Lead Member/Provider
Tufts Health Plan Medicare Preferred
Watertown, MA
05.2007 - 04.2012
- Researched and resolved escalated calls from members, billing offices, or providers.
- Worked with internal partner-departments to resolve enrollment, premium billing and claims issues.
- Worked as a liaison between the members/providers and Tufts Health Plan Medicare Preferred.
- Educated providers on the most up-to-date billing guidelines and proper workflows.
- Printed out stats daily and passed them around to the reps.
- Meet with reps through call coaching to discuss their strong areas as well as areas they need to improve upon.
- Ran the morning reports and entered exceptions when necessary.
- Skilled reps as needed when call volume is high.
- Keep the reps updated with the most up-to-date workflows, systems, policies and procedures.
- Assisted with writing and delivering yearly reviews.
- Assisted with writing and delivering corrective actions, verbal and written.
Customer Relations Rep/ Help Desk
Tufts Health Plan Medicare Preferred
Watertown, MA
04.2005 - 04.2007
- Provide accurate and thorough explanation of Tufts Health Plan Medicare Preferred benefits, eligibility and enrollment policies to members.
- Responsible for Customer inquiries and facilitating in problem resolution
- Act as member advocate by meeting or exceeding customer expectations
- Provide accurate and thorough interpretation of claims issues to billing offices and providers
- Educate reps on how to research and obtain the THPMP benefits, policies and procedures
- Assist with submitting requests for escalated pharmacy issues as well as make changes to update member’s record.
- Worked on complaints filed through CMS.
- Assist with processing reimbursements to members.
- Assisted with educating reps on the inconsistency with auto deduction with SSA.
Provider Advocate
Tufts Associated Health Plan
Watertown, MA
09.2001 - 08.2004
- Researched and resolved escalated claim issues with billing and physician offices
- Reviewed complex billing issues and handled escalated calls from billing offices
- Worked with internal partner-departments to resolve claim processing issues
- Worked as a liaison between Tufts Health Plan and billing/physician offices
- Assisted the call center staff when call volume was high
Medical Secretary/Office manager
George Dickstein, MD, PC
Waltham, MA
06.1996 - 02.2001
- Answered phones, kept an organized log of messages, and scheduled patient appointments/ procedures
- Trained new employees with office protocol
- Ensured patient charts were accurate to Dr. Dickstein’s instruction
- Ordered office supplies and equipment
- Maintained all up to date patient demographic, billing, and insurance information
- Interacted with Dr. Dickstein to discuss scheduling issues, company billing, payroll, insurance, and banking services
- Processed referrals and pre-certification approvals for procedures with the appropriate insurance company
Education
Associate of Science - Medical Administrative Office Program
Aquinas College
Newton, MASkills
- Customer service
- Communication
- Time management & Organization
- Adaptability & Flexibility
- Technical/Hard Skills (Excel, Word, EPIC)
- Team Player
Timeline
Office assistant II / Surgical Scheduler
Boston Hand to Shoulder
02.2019 - Current
Team Lead Member
Tufts Health Plan Medicare Preferred
02.2016 - 06.2018
Customer Relations Supervisor
Tufts Health Plan Medicare Preferred
04.2012 - 02.2016
Team Lead Member/Provider
Tufts Health Plan Medicare Preferred
05.2007 - 04.2012
Customer Relations Rep/ Help Desk
Tufts Health Plan Medicare Preferred
04.2005 - 04.2007
Provider Advocate
Tufts Associated Health Plan
09.2001 - 08.2004
Medical Secretary/Office manager
George Dickstein, MD, PC
06.1996 - 02.2001
Associate of Science - Medical Administrative Office Program
Aquinas College