Rene Long
Medical Records Administration
Horizon City,TX
Summary
Dedicated to providing superior support for Veterans and Providers. Assisting Veterans with reliable information regarding healthcare coverage, finance options and documentation requirements. Well-versed in scheduling and database management functions. Excels at identifying client needs and concerns to improve engagement strategies and overall service. Recognized for resolving customer complaints with integrity and professionalism to maintain customer satisfaction and retention.
Overview
17
17
years of professional experience
Work History
Patient Service Representative
TriWest Healthcare Alliance
03.2019 - Current
- Facilitated communication between patients and various departments and staff.
- Applied administrative knowledge and courtesy to explain procedures and services to patients.
- Helped address client complaints through timely corrective actions and appropriate referrals.
- Organized patient records and database to facilitate information storage and retrieval.
- Contributed to reduction of accounts receivables by adhering to predetermined policies and procedures to recover amounts due from patients.
- Resolved patient financial problems with guidance from documented guidelines and procedures.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Performed patient scheduling and registration functions to serve as initial contact point for medical office visits.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Followed document protocols to safeguard confidentiality of patient records.
Claims Service Representative
TriWest Healthcare Alliance
03.2019 - Current
- Checked documentation for accuracy and validity on updated systems.
- Verified client information by analyzing existing evidence on file.
- Generated, posted and attached information to claim files.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Processed and recorded new policies and claims.
- Posted payments to accounts and maintained records.
- Maintained confidentiality of patient finances, records and health statuses.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Communicated effectively with staff members of operations, finance and clinical departments.
- Calculated adjustments, premiums, and refunds.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
- Coordinated with contracting department to resolve payer issues.
- Answering internal and external questions and inquiries.
Outbound Sales / Customer Service
Empire Today Flooring
07.2010 - 03.2019
- Delivered superior customer service to retain existing customers and attract future customers.
- Informed customers of sales and promotions to build customer base, boost traffic and increase customer loyalty.
- Determined customer needs and interests to recommend carpet or flooring to customers.
- Handled customer inquiries and high volume calls to solve billing and ordering problems, independently resolving issues.
- Exceeded call monitoring expectations through accurate reporting and processing.
- Worked independently with minimal supervision.
- Built relationships with customers and community to promote long term business growth.
- Negotiated prices, terms of sales and service agreements.
- Prioritized tasks and projects to meet tight deadlines.
- Worked with sales team to collaboratively reach targets, consistently meeting or exceeding personal quotas.
- Liaised between clients and support team to quickly resolve issues.
- Kept detailed records of daily activities through online customer database.
Data Entry
Datamark
05.2007 - 04.2010
- Completed data entry tasks with accuracy and efficiency.
- Scanned documents and saved in database to keep records of essential organizational information.
- Corrected data entry errors to prevent later issues such as duplication or data degradation.
- Verified accuracy of data before transcribing.
- Reviewed completed work for compliance with regulations.
Education
High School Diploma -
Sunset High School
EL Paso, TXSkills
- Registration and Scheduling
- Explaining Policy and Procedures
- Patient Account Reviews
- Patient Confidentiality and Data Security
- Patient Needs Assessment and Referral
- Detailed Call Documentation
- Insurance Verification
- Medical Services Administration
- Billing Issue Resolution and Support
- Referral Verification
- Time Management
- Eligibility Determinations
- Issue and Complaint Resolution
- Problem Resolution
Timeline
Patient Service Representative
TriWest Healthcare Alliance
03.2019 - Current
Claims Service Representative
TriWest Healthcare Alliance
03.2019 - Current
Outbound Sales / Customer Service
Empire Today Flooring
07.2010 - 03.2019
Data Entry
Datamark
05.2007 - 04.2010
High School Diploma -
Sunset High School
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