Miriam Barashari
Ridgecrest,USA
Summary
A highly experienced and dedicated Customer Service Representative with 10+ years of experience resolving complex customer inquiries. Proven ability to establish and maintain excellent communication and relationships with clients. Dedicated to identifying customer needs and delivering effective solutions to all problems. Highly trustworthy and with superior work ethic. Responsible and ability to multi-task effectively. Excellent interpersonal skills, ability to work well with others, in both supervisory and support staff roles.
Overview
36
36
years of professional experience
Work History
Revenue Cycle Representative
Resolv Healthcare
01.2023 - Current
- Contributed to the development of departmental goals and objectives, driving continuous improvement efforts within the revenue cycle team.
- Maintained up-to-date knowledge of payer policies, regulations, and guidelines, ensuring compliance throughout the revenue cycle process.
- Proactively identified underpayments by comparing remittance advice against contracted rates.
- Established strong working relationships with insurance representatives to expedite claim resolution.
Revenue Cycle Representative
Ridgecrest Regional Hospital
01.2019 - 01.2023
- Build invoices/claims from the Clinic and Hospital Facility
- Help patients understand billing and charges for which they are responsible
- Accurate logging of payments received from patients while maintaining current records and balances
- Researches any overdue account balance that is fully or partially unpaid and follows up by mail and/or phone to insurance carriers and resubmit billing as needed
- Reviews claims denied for payment and underpaid claims
- Verifies payment information adjustments
- Answer and resolve inbound inquiries and issues regarding patient account statements, explanation of benefits, balance due, and other patient and insurance billing scenarios;
- Billing- sending out claims and patient statements for reimbursement
Patient Access Representative I
Ridgecrest Regional Hospital
01.2014 - 01.2019
- Registered patient from Tower, Emergency Room and Outpatient Departments as well as Hospital admission from Physicians’ offices
- Pre-registered patient for their scheduled procedure or test
- Verify and correct demographic information, select correct guarantor and emergency contacts on all registrations/pre-admissions
- Verify, update patients insurance and obtain necessary pre-authorization letter during the registration and pre-registration
- Collects all co-payments and deductibles at the time of registration/pre-registration
- Completes registrations / pre-registrations with correct Primary Care MD, Admitting MD and Attending MD
- Able to practice AIDET with patients, families and co-workers
- Possess an understanding of medical terminology and procedures
- Knowledge of CPT codes and Order codes for Medicare patients
- Ability to maintain ABN and MSP forms for Medicare patients
- Knowledge and ability to follow EMTALA and HIPAA regulations daily including hospital guidelines on Advance Directives
- Maintain registration compliance error rate, as calculated by AccuReg by maintaining a Final Accuracy Rate of 95% or above
- Performs a variety clerical duties relating to the process of patient’s admission
- Ability to review and make corrections on all the work before shift ends
User Acceptance Tester III/QA Analyst/Business Analyst
Farmers Insurance Group
01.2000 - 01.2013
- Developed User Acceptance Testing plans, including Test Objectives, Test Scenarios, and Quality Criteria and measurement techniques
- Analyzed test results and validated acceptance criteria are met
- Reviewed documentation and test objectives and provided feedback on design and functionality of web application as part of project life cycle meetings
- Supported subject matter experts in creating and approving screen mockups
- Assessed and approved solution design documents and test objectives for offshore team
- Researched and reproduced issues reported by agents to determine severity and escalate appropriately
- Mentored lower level colleagues and provided training, as required
Customer Service Representative
Farmers Insurance Group
01.1998 - 01.2000
- Provided excellent customer service to policyholders and/or agents within appropriate escalation ranges
- Conferred with customers/agents by telephone or in person to provide information about products or services, cancel accounts, or obtain details of complaints
- Corresponded with insured or agent to obtain information or inform them account status or changes
- Processed policy change requests in a timely manner
- Kept records of customer interactions or transactions, recorded details of inquiries, complaints, or comments, as well as actions taken
- Determined charges for change requested, collected deposits or payments, or arranged for billing
- Key entry of data in response to inquiries
- Maintained good communications skills
- Consistently maintained a positive attitude and enjoyed helping people
- Maintained solid customer relationships by handling questions and concerns with speed and professionalism
Mail Clerk/Accounts Clerk/Policy Coder
Farmers Insurance Group
01.1989 - 01.1998
- Placed incoming or outgoing letters or packages into sacks or bins based on destination or type, and place identifying tags on sacks or bins
- Sorted and routed incoming mail, and collected outgoing mail, using carts as necessary
- Researched missing payments and journal to the correct account
- Provided information by answering questions and requests
- Data entry and coding according to company procedures
- Performed clerical tasks, such as filing, maintaining files for each policyholder
Education
Associate of Arts - General Studies
University of Phoenix
Phoenix, AZHigh School Diploma - General Studies
Project 6 High School
01.1981
Skills
- Customer Service
- Patient Relation
- Leadership skills
- Computer skills
- Attention to detail
- Multi-tasking
- Time management
- Responsible
- Reliable
- Friendly
- Organized
- Verbal communication
- Written communication
- Flexible
- Adaptable
- Problem solving
- Microsoft Office (Word, Excel, Power Point, Visio)
Timeline
Revenue Cycle Representative
Resolv Healthcare
01.2023 - Current
Revenue Cycle Representative
Ridgecrest Regional Hospital
01.2019 - 01.2023
Patient Access Representative I
Ridgecrest Regional Hospital
01.2014 - 01.2019
User Acceptance Tester III/QA Analyst/Business Analyst
Farmers Insurance Group
01.2000 - 01.2013
Customer Service Representative
Farmers Insurance Group
01.1998 - 01.2000
Mail Clerk/Accounts Clerk/Policy Coder
Farmers Insurance Group
01.1989 - 01.1998
High School Diploma - General Studies
Project 6 High School
Associate of Arts - General Studies
University of Phoenix
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