Marilyn Taylor
Austin,TX
Summary
Astute customer service professional with knowledge of service delivery and proven multitasking abilities. Committed to maintaining professional relationships to increase profitability and drive business results. Knowledgeable in the many facets of Medicare and Medicaid.
Diligent authorization verification specialist with 7 years of experience addressing customer requests and concerns. Expert at providing relevant information and options to successfully resolve issues. Upbeat and energetic handling difficult situations through resourcefulness and adaptability..
Overview
10
10
years of professional experience
Work History
Customer Service Advocate-Remote
Pyramid Consulting
11.2023 - 03.2024
- Resolved customer inquiries on claims and authorizations, providing dedicated support and ensuring satisfactory solutions as a primary contact
- Maintained strict adherence to HIPAA regulations and company policies to uphold confidentiality and professionalism in all customer engagements
- Guided clients in navigating member portals, understanding benefits, and managing appeals, enhancing their experience and knowledge of services.
Quality Assurance
Balance Staffing - Remote
07.2023 - 10.2023
- Reviewed client life insurance applications, ensuring adherence to performance metrics while maintaining professional standards
- Complied with HIPAA regulations and state laws, securing necessary consents for specialized signature requirements
- Documented clients' medical histories and prescription information, supporting the accuracy of the underwriting process.
Clinical Intake Specialist/UM - Remote
Healthcare Support Staffing
11.2022 - 03.2023
- Processed inbound prior authorization and referral requests with precise data entry, following established update protocols
- Utilized Care Management software to manage pre-certification and inpatient notifications, consistently meeting regulatory deadlines
- Routed pre-certification and referral inquiries to appropriate departments or vendors, maintaining adherence to quality assurance standards.
Billing Specialist
Care Centrix - Remote
07.2021 - 11.2022
- Managed and accurately recorded a high volume of financial transactions by processing daily incoming payments
- Collaborated with healthcare insurers to rectify billing and claims issues, guaranteeing precise and prompt payment processing
- Improved client satisfaction by efficiently resolving customer inquiries and concerns, focusing on effective communication and problem resolution.
Contact Center Representative II Remote
Medtronic - San Antonio, TX
10.2016 - 07.2021
- Demonstrated ability to handle over 50 calls per day, consistently meeting performance metrics and ensuring adherence to quality standards
- Elevated customer awareness of Medicare guidelines for diabetic supplies, resulting in improved comprehension and adherence to medical protocols.
- Leveraged comprehensive understanding of product financial implications to enhance sales through strategic recommendations.
Customer Care Representative
Aerotek - San Antonio, TX
09.2015 - 10.2016
- Addressed and resolved medical pump therapy queries, ensuring detailed and compassionate customer assistance
- Increased client contentment through the prompt and empathetic resolution of various issues
- Managed a substantial number of inbound and outbound customer service interactions, maintaining high-quality support
- Processed required authorizations for Medicare and Commercial Health Plans to facilitate continuous pump therapy access.
Customer Care Representative
Maximus - San Antonio, TX
10.2014 - 09.2015
- Ensured adherence to HIPAA regulations, providing high-quality customer support for Medicare/Medicaid and SNAP program inquiries
- Utilized strong communication skills to submit appeals and resolve customer requests through tailored solutions
- Maintained compliance with service level agreements by managing call times and meeting performance metrics, leveraging complex computer systems for information retrieval.
Insurance Verification Specialist
Dental & Medical Staffing - Portland, OR
05.2014 - 07.2014
- Verified Medicare and Medicaid eligibility on a monthly basis, ensuring uninterrupted coverage for patients in compliance with healthcare regulations
- Liaised with insurance providers to confirm patient benefits, securing required referrals and authorizations while upholding stringent confidentiality standards.
Customer Service Representative
Rotech-Centennial Medical Equipment - Portland, OR
04.2013 - 03.2014
- Ensured consistent delivery of oxygen services by verifying insurance eligibility and obtaining required prior authorizations for patient treatments
- Managed order processing and coordinated delivery schedules to align with patient needs and maintain up-to-date system records.
Mail Handler/Interim Supervisor/Union Representative
US Postal Service - Richmond, VA
10.1985 - 08.2012
- Managed the accurate sorting and distribution of mail, ensuring compliance with postal standards and delivery timelines
- Led team members to uphold schedule adherence, enhancing productivity and achieving key deadlines
- Served as a liaison between staff and executive management, communicating feedback to facilitate smooth operations and sustain staff morale.
Medical Assistant
CIW, Correctional Institution for Women- Corona, CA
06.2000 - 05.2001
- Managed patient intake processes, accurately documenting medical histories, vital signs, and medication information in a secure database to facilitate effective clinical assessments
- Administered medical inventory control and coordinated appointment scheduling to optimize clinical operations
- Liaised with healthcare professionals to ensure clear communication and continuity of patient care.
Education
Associate of Science: Medical Billing Coding -
Ultimate Medical Academy
06.2012
Skills
- OMNI Software
- MS Office (Word, Excel, Outlook)
- EMR Systems
- Central Point
- HIPAA Guidelines
- Insurance Authorizations
- Center for Medicare & Medicaid /CMS
- Embark
- One Source
- CPT Coding
- 48 WPM
- Patient Referral
- Data Entry Software
- Computer Proficiency
- Calabrio One
- Medical Terminology (Intermediate)
- Patient Healthcare Information Access
- Teamwork and Collaboration
- Tru-Care
- Call Center
- Remote Experience
- Detail Oriented
- Softheon
- Time Management
- Multi-tasking
- Medical Billing
- Commercial Insurance
- DME
- ABN
- AOB
- EOB
- CLAIMS
- PBM
- EHR
- Probity
- Autodidactic
- Versatility
- Experiential Learning
- Email Communication
- Organizational Skills
- Problem-solving
- Interpersonal Skills
- Persistence
References
References available upon request.
Timeline
Customer Service Advocate-Remote
Pyramid Consulting
11.2023 - 03.2024
Quality Assurance
Balance Staffing - Remote
07.2023 - 10.2023
Clinical Intake Specialist/UM - Remote
Healthcare Support Staffing
11.2022 - 03.2023
Billing Specialist
Care Centrix - Remote
07.2021 - 11.2022
Contact Center Representative II Remote
Medtronic - San Antonio, TX
10.2016 - 07.2021
Customer Care Representative
Aerotek - San Antonio, TX
09.2015 - 10.2016
Customer Care Representative
Maximus - San Antonio, TX
10.2014 - 09.2015
Insurance Verification Specialist
Dental & Medical Staffing - Portland, OR
05.2014 - 07.2014
Customer Service Representative
Rotech-Centennial Medical Equipment - Portland, OR
04.2013 - 03.2014
Medical Assistant
CIW, Correctional Institution for Women- Corona, CA
06.2000 - 05.2001
Mail Handler/Interim Supervisor/Union Representative
US Postal Service - Richmond, VA
10.1985 - 08.2012
Associate of Science: Medical Billing Coding -
Ultimate Medical Academy