Michelle Jones
Kingwood
Summary
Dynamic Customer Relations Specialist with a proven track record at Hartford, excelling in claim processing and insurance verification. Adept at delivering exceptional customer service and ensuring HIPAA compliance, I thrive in fast-paced environments, consistently enhancing patient experiences and streamlining operations. My attention to detail and strong communication skills drive successful outcomes.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Customer Relations Specialist
Hartford
Sunrise
11.2024 - Current
- Reviewed claim files for accuracy, identifying discrepancies and necessary corrections.
- Processed claims efficiently while verifying documentation and compliance requirements.
- Analyzed claimants' benefits and eligibility based on established guidelines.
- Provided excellent customer service by addressing inquiries promptly and professionally.
Gate Guard
Envera
02.2024 - Current
- Manage visitor access, enhance security protocols, and maintain vigilant oversight of entry/exit points, ensuring a safe environment for all stakeholders.
- Coordinate with security teams to streamline check-in processes, fostering a welcoming atmosphere while upholding strict access control measures.
- Meticulously monitor premises, swiftly identify potential security breaches, and implement preventive measures to maintain facility integrity.
Physician Practice Patient Representative
Baptist Health
01.2023 - 02.2024
- Verified patient demographics, insurance coverage, and payment information.
- Scheduled appointments and maintained patient records.
- Answered phone calls and responded to patient inquiries.
- Collected patient payments accurately and efficiently.
- Assisted with patient referrals and follow-up care.
- Greeted patients upon arrival and obtained patient information and signature for registration purposes.
- Verified insurance eligibility and coverage to ensure proper reimbursement for services.
- Processed payments and collected copays according to established policies and procedures.
- Recorded patient information accurately and updated patient and facility information in the computer system.
- Verified patient's insurance coverage, collected copayments, and processed payments.
- Resolved patient inquiries and complaints in a professional and timely manner.
- Ensured adherence to HIPAA guidelines and regulations.
Patient Access Representative
Holy Cross
12.2021 - 12.2022
- Facilitated patient check-in and registration processes for seamless access to services.
- Educated patients on insurance coverage and payment options during appointments.
- Applied HIPAA privacy and security regulations while handling patient information.
- Collected co-pays and other payments from patients at time of service.
- Answered phones promptly in a professional manner.
- Greeted patients and visitors in a courteous and professional manner.
Patient Access Representative
Memorial Healthcare System
01.2019 - 12.2021
- Facilitated patient check-in and registration processes for seamless access to services.
- Educated patients on insurance coverage and payment options during appointments.
- Collected co-pays and other payments from patients at time of service.
- Answered phones promptly in a professional manner.
- Verified insurance coverage for services provided by the facility.
- Registered patients by completing face-to-face interviews to obtain demographic, insurance, and medical information.
Education
High-school -
Everglades High School
Miramar06.2017
Skills
- Claim processing
- Insurance verification
- Customer service
- HIPAA compliance
- Communication skills
- Attention to detail
- Patient scheduling
References
- Jennifer Berger, 9546320513
- Rocio Gonzalez, 7863745218
Certification
- Yellow Belt Certification
Timeline
Customer Relations Specialist
Hartford
11.2024 - Current
Gate Guard
Envera
02.2024 - Current
Physician Practice Patient Representative
Baptist Health
01.2023 - 02.2024
Patient Access Representative
Holy Cross
12.2021 - 12.2022
Patient Access Representative
Memorial Healthcare System
01.2019 - 12.2021
High-school -
Everglades High School
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