Emerald Thompson
Houston,TX
Summary
Strong leader and problem-solver dedicated to streamlining operations to decrease costs and promote organizational efficiency. Uses independent decision-making skills and sound judgment to positively impact company success.
Overview
10
10
years of professional experience
Work History
Healthcare Customer Service Representative /Medical Claims Processor
ModMed
08.2021 - Current
- Manage a high volume of incoming calls from patients, healthcare providers, and insurance companies regarding insurance eligibility, claims status, and billing inquiries.
- Quickly and accurately determine patients' insurance coverage for specific healthcare services or treatments..
- Submit claims to insurance companies electronically or via mail, ensuring all required information is included and accurately entered.
- Handle inbound calls .Manage a high volume of incoming calls from patients, healthcare providers, and insurance companies regarding insurance eligibility, claims status, and billing inquiries.
Insurance Verification Specialist
Walgreens
12.2019 - 08.2021
- Assist with the preparation and submission of insurance claims by providing accurate insurance information and documentation.
- Resolve discrepancies between insurance verification details and claims submitted to ensure proper processing and payment.
- Verify patient insurance coverage and eligibility prior to services being rendered to ensure accurate billing and coverage.
- Contact insurance companies and payers to confirm patient benefits, co-payments, deductibles, and out-of-pocket expenses. Obtain and document required pre-authorizations or pre-certifications for medical procedures or treatments.
Patient Account Specialist
Ciox Healthcare
08.2017 - 12.2019
- Handle high volumes of inbound calls from patients regarding their accounts, including billing inquiries, payment plans, and account updates.
- Provide detailed information about patient accounts, including charges, payments, and insurance coverage.
Verify patient insurance coverage and benefits, including co-payments, deductibles, and out-of-pocket expenses. - Process and review insurance claims, ensuring accurate submission to insurance carriers and follow-up on unpaid or denied claims.
- Process patient payments, including co-pays, deductibles, and balance payments, through various payment methods such as credit/debit cards, checks, or online payments.
Medical Billing Coordinator
AppleOne
05.2014 - 08.2017
- Review and verify medical bills and claims to ensure they are complete, accurate, and comply with payer guidelines.
- Address and resolve billing issues, including rejected or denied claims, by working with insurance carriers and healthcare providers.
- Prepare and submit insurance claims using billing software and electronic claim systems. Monitor the status of submitted claims and follow up with insurance companies to ensure timely processing and payment.
- Verify patient insurance eligibility and benefits prior to services being rendered to ensure accurate billing.
Education
High School Diploma -
West Side High School
Houston, TXSkills
- Remote Operations
- Email Support
- Medical Billing Support
- Chat Support
- Call Center Operations
- Medical terminology knowledge
- Insurance Verification
- Appointment Scheduling
- Customer Service
- Inbound/Outbound Calling
- HIPAA Compliance
- Payment Processing
- Data Entry
- Claims
- Eligibility Determination
- Insurance Verification
- Enrollment
- Customer Interaction
- Customer Relationship Management
- Schedule Management
Timeline
Healthcare Customer Service Representative /Medical Claims Processor
ModMed
08.2021 - Current
Insurance Verification Specialist
Walgreens
12.2019 - 08.2021
Patient Account Specialist
Ciox Healthcare
08.2017 - 12.2019
Medical Billing Coordinator
AppleOne
05.2014 - 08.2017
High School Diploma -
West Side High School
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