Pam Cole
Yuba City,CA
Summary
Account Representative II with 9+ years of experience in managing medical claims and insurance communications. Skilled in following up/resolving medical claim denials, filing appeals, reviewing medical records, met assignment and project deadlines, maintaining the utmost confidentiality. Possess an A.A degree, proficient in Microsoft, Word, Excel and Power-point, and insurance financial classes. Seeking long-term growth in a company focused on patient care and operational efficiency.
Overview
13
13
years of professional experience
Work History
Microblading Artist
Self-employeed
Yuba City, CA
09.2023 - Current
- Maintained full schedule of appointments with over 6 clients per week.
- Created unique looks matching individual client preferences.
- Worked with high attention to detail to complete precise, long-lasting eyebrows.
- Taught clients how best to care for their eyebrows and prevent problems during the healing process.
- Addressed client questions, concerns and requests directly for maximum satisfaction.
- Kept workspace clean, organized and well-stocked for upcoming appointments.
- Developed loyal following of clients by providing high-quality services.
Account Representative II
Sutter Physician Services
Sacramento, CA
09.2014 - 09.2023
- Proficient in EPIC program
- Knowledgeable multiple types of insurance financial classes such as PPO, HMO, Medicare and Medical
- Processed claims, resolved denials, posted payments, filed appeals, verified eligibility, reviewed medical records for accuracy, filed appeals for denied claims, reviewed authorization issues
- Met quality and production requirements monthly
- Completed assignment/projects before deadlines
- Maintained comprehensive database for enrollment data, claim submission and payment information.
- Streamlined complex claim processes for improved efficiency.
- Monitored reports to identify claims issues and worked with adjusters to resolve problems.
- Identified revenue opportunities and implemented cost-reduction strategies.
- Managed accounts receivable including collections from delinquent accounts.
- Actively participated in weekly team meetings to enhance project outcomes.
Pharmacy Technician
CVS Pharmacy
Auburn Folsom Rd. Granite Bay, CA 95746
03.2013 - 09.2014
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
- Stocked, labeled, and inventoried medication to keep accurate records.
- Enhanced pharmacy workflow by assisting pharmacists with medication dispensing, labeling, and packaging.
- Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
- Promoted patient confidentiality by adhering to HIPAA regulations when handling personal information during transactions.
- Provided exceptional customer service, fostering positive relationships with both new and returning patients at the pharmacy counter.
- Entered and processed patients' prescriptions into internal system.
Education
Bachelor of Arts - Psychology
Southern New Hampshire University
New Hampshire, OH12-2026
Certification - Foundations of Project Management
Coursera
02-2026
Associates of Arts Degree - Pharmacy Technician
Heald College
Roseville, CA01-2013
Certified CNA At The Fountains Ride Out Hospital -
Sutter County One Stop
06-2009
Medical Coding and Billing - Medical Billing And Coding
Sutter County One Stop
Yuba City, CA05-2006
Skills
- Accurately type 85 WPM
- Proficient in all Microsoft applications
- Database Management
- Nine (9) years of quality work, patient care and ensuring the confidentiality of patient information, Revenue cycle operations & improvement
- Problem Solving
- Adaptability
- Collaboration
- Strong work ethic
- Patient confidentiality
- Time Management
- Critical Thinking
- Attention to Detail & Organizational Skills
- Performance dashboards & KPI monitoring
Timeline
Microblading Artist
Self-employeed
09.2023 - Current
Account Representative II
Sutter Physician Services
09.2014 - 09.2023
Pharmacy Technician
CVS Pharmacy
03.2013 - 09.2014
Bachelor of Arts - Psychology
Southern New Hampshire University
Certification - Foundations of Project Management
Coursera
Associates of Arts Degree - Pharmacy Technician
Heald College
Certified CNA At The Fountains Ride Out Hospital -
Sutter County One Stop
Medical Coding and Billing - Medical Billing And Coding
Sutter County One Stop