Mary Kinney

• Managed medical billing processes, including insurance verification and claims submission, to optimize revenue
• streams and improve financial operations.
• Engaged the coding follow-up team for any medical
• necessity or coding-related appeals.
• Initiated insurance follow-up on new, aged, and unresolved
• claims to ensure maximum reimbursement.
• Submitted appeals and reconsiderations on claim rejections,
• underpayments, and denials.
• Set follow-up activities based on the status of the claim.
• Reviewed EOBs to verify that the allowed amount was paid based on the agreement.
• on insurance contracts.
• Communicated identified payer trends, such as denials for specific procedures, diagnosis codes, or other identified issues.

• Providing Customer Support – Greeting customers, answering questions, and resolving complaints professionally.
• Processing Transactions – Handling cash register operations, processing payments, and assisting with returns/exchanges.
• Assisting with Prescriptions – Helping customers with prescription pickups, answering basic pharmacy-related questions, and directing them to pharmacists for further assistance.
• Stocking and organizing – restocking shelves, organizing products, and ensuring the store remains clean and accessible.
• Promoting Sales and Rewards Programs – Informing customers about promotions, discounts, and the CVS ExtraCare rewards program.
• Handling Phone Calls – Answering customer inquiries over the phone regarding store hours, product availability, and prescription refills.
• Maintaining Compliance – Following CVS policies, HIPAA regulations, and safety guidelines to ensure a secure environment.

• Demonstrate strong attention to detail, organization skills, and serve as a resource to customers on all Direct Generals products and services

• Works independently under general supervision. Work is reviewed for overall adequacy in meeting objectives.

Establish and maintain relationships with lead sources and settlement service providers.

• Develop and maintain business relationships with internal and external referral sources

• Assignments are regularly monitored and work is screened according to adjuster standards

• Handle inbound service calls by providing accurate and complete information

• Handled a high volume of inbound customer calls, addressing inquiries, resolving issues, and providing product information.

• Maintained a high level of customer satisfaction through effective communication and problem-solving.

• Documented customer interactions in the CRM system, ensuring accurate and detailed records.

• Collaborated with team members to share best practices and improve overall team performance.

Achievements:

• Recognized as "Employee of the Month" for consistently exceeding performance targets and providing exceptional customer service.

Successfully contributed to an increase in customer satisfaction scores through efficient issue resolution.