Tenika Lamons
El Paso,TX
Summary
Enthusiastic client services professional with strong background directly interfacing with industry customers. Well-versed in products, services and consumer trends. Dependable achiever committed to holding highest ethical standards and maintaining customer trust.
Overview
22
22
years of professional experience
Work History
Remote Customer Service Representative
State Collection Service
Madison, Wisconsin
07.2024 - Current
- Help patients navigate medical billing, insurance claims, payments and answer patient questions about medical billing, insurance claims, and payments.
- Assist with insurance claims by helping patients with insurance claims, including tracking denials.
- Provide financial assistance applications by helping patients apply for financial assistance.
- Create affordable payment plans that for patients.
- Resolve existing claims and track denials
- Provide pre-service financial clearance to patients with an estimated balance before their service.
- Resolved complex problems by working with other departments to provide solutions that meet customer needs.
- Provided exceptional customer service to ensure customer satisfaction.
- Identify customer needs to ensure the customer is provided complete and accurate information. Acknowledging and resolving customer complaints and difficult situations. Process required transactions via web-based applications. Submit research requests in a concise yet accurate manner.
Lead Medical Support Assistant
William Beaumont Army Medical Center
Fort Bliss , Texas
08.2014 - 12.2023
- Provided administrative support to the medical team and patients, including scheduling appointments, filing patient records, and answering phones.
- Provided compassionate support, addressing patient concerns and inquiries in a professional manner.
- Maintained strict confidentiality, adhering to HIPAA regulations while handling sensitive patient information.
- Maintained a high degree of professionalism and composure in high-stress situations, ensuring the well-being of patients and staff alike.
- Improved patient satisfaction by efficiently scheduling appointments and managing phone lines.
- Organized meetings between physicians and other healthcare professionals as needed.
- Utilized excellent interpersonal skills to build strong relationships with patients,physicians, and other healthcare professionals
- Resolved customer service inquiries in a timely manner while demonstrating exceptional customer service skills.
- Register or update patient demographic information in the mini registration to ensure data base system is always current and accurate. Responsible for checking patients in for appointments and verifying their identity.
- Inform patients of other health care, telephone numbers, clinic hours, complaint procedures,transportation, and medical record requirements. Advises patients of alternate Health care on TRICARE. Capable to look up lab results, radiology reports, medication summaries, and make telephone consults.
- Responsible for answering multi-line phone calls and securing appointments for patients in MHS Genesis Health Portal, Composite Health Care System. (CHCS ). Revised telephone recorded message after same day appointments are booked to inform patients that the Patient Appointment System is closed and includes the appropriate instructions as to when patient can call back for the next available appointment.
- Responsible and proficient in booking appointments for the clinic, referrals, self-referrals, physicaltherapy, optometry, hearing, immunization, Warrior Transition Unit (WTU) soldiers, and the proper protocols for Behavioral patient and managing referrals.
- Assisted in The Exceptional Family Member Program (EFMP) paperwork(DD5888 and 7426 forms) forfamily members who has a diagnosed physical, intellectual, or emotional condition.
- Assisted wherever I was needed.
Claims Auditor Processor
Bienvivir Senior Health Services
El Paso, TX
08.2009 - 04.2012
- Maintained a high level of accuracy in reviewing and verifying claim information to ensure proper reimbursement.
- Utilized problem-solving skills to identify issues that could affect payment or processing of claims.
- Presented audit results to management along with potential solutions for identified problems.
- Prioritized daily tasks to complete workloads within department's expected timeframe.
- Evaluated policies and procedures for accuracy and adherence to state and federal laws.
Claims Audit Processor
Foresight TPA Inc.
El Paso, TX
03.2003 - 12.2008
- Identified fraudulent activities by conducting detailed audits on suspicious claims, protecting company resources.
- Participated in ongoing professional development opportunities to stay current on industry trends, enhancing personal skill set and benefitting the organization.
- Improved customer satisfaction by providing timely and accurate feedback on submitted claims, facilitating a positive experience.
- Enhanced claim accuracy by meticulously reviewing and auditing claim submissions.
- Interacted regularly with peers and management to pursue continuous improvement of facility operations and promote teamwork-focused environment.
- Maintained a high level of accuracy in reviewing and verifying claim information to ensure proper reimbursement.
- Utilized problem-solving skills to identify issues that could affect payment or processing of claims.
- Reviewed denied claims in order to determine if additional information is needed before resubmission or appeal process can be initiated.
Education
Certificate of Technical Studies - Medical Billing, Coding And Front Desk
International Business College
El Paso, TX08-2021
High School Diploma -
Stephen F Austin High School
El Paso, TX06-1994
Skills
- Communication
- Problem-solving
- Empathy
- Adaptability
- Complaint resolution
- Account updating
- Scheduling
- Spreadsheets
- HIPAA Compliance
- Knowledge Critical thinking abilities
- Staff Training and Development Insurance Verification
- Knowledge of ICD-9, HCPC, CPT connections and guidelines Knowledge of Medicare and Medicaid payment rules
- Claims Adjudication software Medical Manager, Word Perfect, MS Excel, MS
- Word, MS Access
- Windows Billing for hospital; DME, Surgery, Anesthesia,
- Physicians services, Medicare and Medicaid billing
- Clerical support
Timeline
Remote Customer Service Representative
State Collection Service
07.2024 - Current
Lead Medical Support Assistant
William Beaumont Army Medical Center
08.2014 - 12.2023
Claims Auditor Processor
Bienvivir Senior Health Services
08.2009 - 04.2012
Claims Audit Processor
Foresight TPA Inc.
03.2003 - 12.2008
Certificate of Technical Studies - Medical Billing, Coding And Front Desk
International Business College
High School Diploma -
Stephen F Austin High School