Jessica Johnson

• Greeted and assisted patients, ensuring a welcoming environment.
• Managed multi-line phone system, directing calls to appropriate staff members.
• Scheduled appointments using electronic health record systems for improved efficiency.
• Processed patient intake forms, verifying information for accuracy and completeness.
• Coordinated communication between patients and healthcare providers to streamline services.
• Responded to patient inquiries promptly, resolving concerns or redirecting as necessary.
• Assisted with billing and insurance verification processes to support administrative functions.

• Assisted in executing necessary administrative tasks to facilitate seamless patient check-in and check-out processes.
• Delivered high-quality customer service at each patient interaction, whether in person or via phone.
• Exhibited professionalism by greeting patients promptly with a smile and expressing gratitude upon their departure.
• Managed incoming phone calls, providing timely and courteous service consistently.
• Maintained a sense of urgency regarding patient and physician schedules.
• Verified insurance authorizations to confirm completion and assist in generating accurate flow sheets.
• Demonstrated knowledge of standard fees for common visits.
• Processed patient check-outs and collected accurate payments. Coordinated patient flow effectively within the office.
• Performed daily reconciliations, closed the day’s operations, and counted the cash drawer.
• Adhered to all company policies and procedures, including HIPAA regulations.
• Executed general office duties and performed cleaning tasks as designated by the manager.

• Utilize Aetna's systems to manage member inquiries and case documentation efficiently
• Educate members on available health resources and preventive measures
• Provided compassionate emotional support to patients coping with illness or injury, contributing to their overall wellbeing.
• Educated patients on available resources and programs, empowering them to make informed decisions about their health.
• Developed strong relationships with patients and families, cultivating trust and rapport for better engagement in the care process.
• Processes claim referrals, new claim handoffs, nurse reviews, complaints(member/provider), grievance and appeals (member/provider) via target
  system

• Directed verification of enrollment status and initiated record changes as necessary.
• Investigated and resolved enrollment system rejections, effectively managing customer inquiries received through phone and mail.
• Oversaw membership and billing functions to achieve accuracy and timeliness.
• Addressed enrollment process inquiries and maintained the enrollment database, including identification card issuance.
• Evaluated eligibility and applied relevant contract language for each assigned case.
• Cultivated strong customer relations by collaborating with various company functions to ensure timely handling of customer requests.
• Analyzed data to tackle operational challenges and improve customer service experiences.
• Facilitated information access for external and internal customers.
• Maintained compliance with HIPAA privacy regulations while managing protected health information.

• Responsible for assisting patients and referral sources with scheduling of appointments.
• Provides exceptional patient service by answering, responding, and routing a high volume of incoming calls from patients, physicians, hospitals, staff and other callers.
• Adheres to internal protocols to ensure consistency and
  quality service.
• Obtains accurate demographic information, and routes
  patient related questions to appropriate area.
• Manages telephone calls as well as patient inquiries via mail or fax; return patient phone concierge, Website, MyChart and CIH appointment requests in a timely manner.

•Clarifies information needed by the caller and determines best course of action to meet the customer's needs.

• Effectively communicates with physicians, patients, and other professionals and returns phone calls promptly.
  

• Managed inbound calls, providing accurate information on health services and appointment scheduling.
• Resolved patient inquiries and concerns efficiently, enhancing overall customer satisfaction.
• Collaborated with healthcare teams to ensure seamless communication between patients and providers.
• Trained new representatives on call protocols and customer service best practices.
• Responsible for answering phone calls for Capital Area Health Network, specifically the medical department, scheduling appointments, leaving messages for providers and other staff members, responding to general inquiries and otherwise providing solutions to callers' questions and concerns.
  
• Engaging in active listening with callers, confirming or clarifying information and diffusing angry clients, as needed.
  
• Understanding and striving to meet or exceed call center metrics while providing excellent consistent customer service.
  
• Ability to read, write, type 25 WPM, follow oral and written instructions, and communicate effectively.
  
• Experience working in a high call volume environment is highly desirable (50 - 80 calls per day on average).

• Maintains HIPAA privacy and best practices when handling patient
  Protected Health Information (PHI).

• Oversaw pharmacy communications concerning third-party billing, ensuring efficient issue resolution for retail pharmacies.
• Cultivated experience in managing high call volumes, averaging 30 - 40 calls per day.
• Identified whether system issues were software or hardware-related and collaborated with appropriate departments for resolution.
• Maintained a detailed log of calls within a proprietary call management system for accountability and analysis.
• Facilitated communication between pharmacies and insurance providers to resolve prescription discrepancies.
• Handled claims involving prior authorizations, Medicare billing, and claim adjustments.
• Applied in-depth knowledge of relevant procedures and policies to enhance service delivery.
• Executed validation of patient insurance data to maintain compliance and accuracy.
• Demonstrated effective verification skills to assess insurance policies.
• Maintained adherence to HIPAA regulations while managing patient protected health information.