Highly motivated business professional with experience in medical billing, insurance claims, and exceptional customer service. Highly effective at conflict resolution and persuasive communication. Knowledgeable about quality assurance and training. Reliable and driven, with strong time management and prioritization abilities. Hardworking and reliable with excellent attention to detail.
Overview
9
9
years of professional experience
Work History
Senior Customer Service Representative
Everise C3 (Remote)
06.2020 - 03.2024
Managed large amounts of inbound and outbound calls promptly
Identified customers' needs, clarified information, researched every issue, and provided solutions and/or alternatives
Explained copays, deductibles, coinsurance, and out of pocket maximum to members
Recognized patterns of inconsistent and/or inaccurate claims filing and billing practices among customers and providers
Researched denied claims, conducted coding reviews of medical records, and supported documentation against denied claims
Built sustainable relationships and engaged patients by taking the extra mile
Maintained a high level of ethical conduct regarding confidentiality and privacy.
Medical Collections Representative
Care Servies (Morrisville, NC)
Morrisville, NC
02.2018 - 03.2020
Managed accounts for healthcare clients, reviewed detailed patient information for payment resolution while abiding HIPPA privacy and security regulations
Contacted insurance companies for benefits investigation and coverage eligibility
Reprocessed denied medical claims using extensive appeal tactics or special appeals processing instructions for commercial and government carriers
Provided itemized billing statements and screen HIPAA authorization forms for hundreds of legal firms
Resolved denied/rejected invoices and prepared payer corrections and or appeals
Reviewed accounts and assisted with resolving outstanding balances with patients from clinic visits forwarding them to in-house collection agents if necessary.
Cashier/Office Assistant
Food Lion
04.2015 - 02.2018
Managed transactions with customers using cash registers
Issued receipts, refunds, change or tickets
Routed telephone and electronic inquiries to appropriate personnel promptly and courteously
Provided administrative support to employees throughout the organization
Consistently provided friendly, personable service to all clients, customers, and staff
Prepared communications, such as memos, emails, invoices, reports, and other correspondence
Created and maintained filing systems, both electronic and physical.
Customer Service Representative/Licensed Insurance Agent at C3 Customer Contact Channels/EveriseCustomer Service Representative/Licensed Insurance Agent at C3 Customer Contact Channels/Everise