Melanie Valrie
Akron,OH
Summary
Highly-motivated employee with 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
22
22
years of professional experience
Work History
Patient Access Liaison
Summa Health
Akron, OH
07.2018 - Current
- Provides a high level of customer service to present a positive impression of Summa Health.
- Applied HIPAA privacy and security regulations while handling patient information.
- Provided assistance with patient registration process including insurance verification and data entry into hospital information systems.
- Applied knowledge of payer requirements and utilized on-line eligibility systems to verify patient coverage and policy limitations.
- Served as a liaison between the clinical staff and other departments within the organization regarding patient access issues.
- Verified patient insurance eligibility prior to appointment or procedure.
- Reviewed eligibility responses to assess patient benefit level and prepare estimates.
Cashier/Customer Service Associate
BJ's Wholesale Club
Akron, OH
11.2001 - 11.2019
- Operated cash register efficiently and accurately, processed payments by cash, check, credit card, gift card or automatic debit.
- Cover the front end to assure that there are no problems with any of the self-check-out registers
- Assist with the training of new cashiers and help in other areas as needed
- Count all the cash and charges to assure that everything balances in my cash drawer.
- Balanced daily transactions on a computerized point-of-sale system.
- Processed returns and exchanges of merchandise in accordance with store policies.
- Kept check-out areas clean, organized and well-stocked to maintain attractive store.
Customer Service Representative
Healthsmart Benefit Solutions
Fairlawn, OH
12.2014 - 06.2018
- Assist members and providers with Benefit Information, Eligibility and Claim Status' via phone and email
- Update referrals, correspondence, coordination of benefits and precertification information
- Advise members and providers of appeal rights for denied claims.
- Answered inbound calls, chats and emails to facilitate customer service.
Customer Service Representative
Summa Care Inc.
Akron, OH
03.2013 - 03.2014
- Answer incoming calls for Summa Care Insurance Company
- Assist members with Benefit Information and Claim Status'
- Route claims to be reprocessed if needed and advise member of Appeal rights
- Follow up with members regarding claim or appeal statuses
- Process premium payments over the phone for individual accounts.
- Escalated customer concerns, issues and requirements to supervisors for immediate rectification.
Customer Service Representative
Ameridial Inc.
Canton, OH
10.2011 - 03.2013
- Answer incoming calls for Emblem Health Insurance Company
- Assist Providers and Members with Claim Status'
- Reprocess denied claims if necessary and advise providers with the correct information on appealing a claim that has been denied.
- Answered inbound calls, chats and emails to facilitate customer service.
Education
High School Diploma -
Central Hower
Akron, OH06-2001
Some College (No Degree) - Early Childhood Education
University of Cincinnati
Cincinnati, OHDiploma - Medical Assisting
Northcoast Medical Academy
Kent, OHSkills
- Certified Medical Assistant
- Certified Phlebotomist
- Knowledgeable of various office programs (ie Microsoft Office, Excel, PowerPoint, Outlook, etc)
- Medical Terminology
- Eligibility Determination
- Insurance Verification
- Insurance Company Knowledgeable
- Multitasking and Organization
- Customer Service
- HIPAA Compliance
- Patient Registration
- Phone and Email Etiquette
Timeline
Patient Access Liaison
Summa Health
07.2018 - Current
Customer Service Representative
Healthsmart Benefit Solutions
12.2014 - 06.2018
Customer Service Representative
Summa Care Inc.
03.2013 - 03.2014
Customer Service Representative
Ameridial Inc.
10.2011 - 03.2013
Cashier/Customer Service Associate
BJ's Wholesale Club
11.2001 - 11.2019
High School Diploma -
Central Hower
Some College (No Degree) - Early Childhood Education
University of Cincinnati
Diploma - Medical Assisting
Northcoast Medical Academy
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