Lisa Hessler
Nanty Glo,PA
Summary
Highly-motivated employee with the desire to take on new challenges. Strong work ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
24
24
years of professional experience
Work History
US Follow Up Representative
R1 Rcm
Chicago, IL
04.2022 - 12.2023
- Reviewed underpaid or denied medical facility claims that were processed by Medicaid to determine the reason for the payment amount or non payment.
- Contacted payers to resolve discrepancies in claim payments and to obtain additional information in order to resolve/balance patients' accounts.
- Filed appeals when necessary in order to obtain payment for claims submitted that were paid incorrectly or denied.
- Contacted patients to obtain additional information when necessary.
- Maintained professionalism on all phone calls.
- Submitted claim inquiries, disputes and appeals via payer portals.
Overpayments Analyst
LifePoint Business Service Center
Johnstown, PA
09.2017 - 04.2022
- Reviewed overpaid medical facility claims to determine the reason for the overpayments.
- Called payers and patients when necessary to obtain additional information needed.
- Refunded payers and/or patients when necessary.
- Performed adjustments on accounts when necessary.
- Reviewing medical policies when necessary to determine eligibility of procedures.
- Maintained professionalism on calls to payers and/or patients.
Customer Service Representative/Lead
Intermediate Marketing Solutions
Johnstown, PA
09.2013 - 09.2017
- Assisted customers in choosing an individual health care plan to meet their budget and healthcare needs.
- Calculated their approximate tax credit.
- Answered plan and benefit questions
- Assisted customer service representative with resolutions to answer customers' inquiries with correct and concise information.
- Responsible for completing floor sheets and reporting employees hours to payroll personnel.
- Responsible for reviewing calls and coaching representatives on call etiquette, proper grammar and quality standards.
- Dealing directly with clients to resolve complex situations and procedures.
- Assisting customers placing vaccine orders and checking status of their orders.
- Assisting customers with online registration and resetting passwords for online accounts.
- Listening to the customers' need and assisting them to the best of my ability.
Customer Service Representative/Lead
Highmark, Inc.
Pittsburgh, PA
11.1999 - 07.2012
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Demonstrated excellent communication skills in resolving product and consumer complaints.
- Developed strong customer relationships to encourage repeat business.
- Provided outstanding service to new and long-standing customers by attending closely to concerns and developing solutions.
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
- Consulted with customers to resolve service and billing issues.
- Used proven techniques to de-escalate angry customers during telephone interactions.
- Mentored new employees on procedures and policies to maximize team performance.
Education
Some College (No Degree) - Medical Secretarial Program
Cambria Rowe Business College
Johnstown, PA10.1996
Certificate of Completion - Distributive Education
Admiral Peary Area Vocational Technical School
Ebensburg, PA06.1985
High School Diploma -
Blacklick Valley High School
Nanty Glo, PA06.1985
Skills
- Critical Thinking
- Conflict Resolution
- Customer Service
- Organizational Skills
- Basic Math
- Friendly, Positive Attitude
- Team Building
- Good Work Ethic
- Needs Analysis
- Experience in Leadership
- Active Listening
- People Skills
Timeline
US Follow Up Representative
R1 Rcm
04.2022 - 12.2023
Overpayments Analyst
LifePoint Business Service Center
09.2017 - 04.2022
Customer Service Representative/Lead
Intermediate Marketing Solutions
09.2013 - 09.2017
Customer Service Representative/Lead
Highmark, Inc.
11.1999 - 07.2012
Some College (No Degree) - Medical Secretarial Program
Cambria Rowe Business College
Certificate of Completion - Distributive Education
Admiral Peary Area Vocational Technical School
High School Diploma -
Blacklick Valley High School