Epic
Tera Hearn
Grand Prairie,TX
Summary
Professional in medical billing with proven track record of optimizing revenue cycles and ensuring accurate claims processing. Strong ability to collaborate with teams and adapt to changing requirements while maintaining high standards. Skilled in coding, insurance verification, and resolving billing discrepancies. Reliable and results-driven, with focus on achieving efficient and compliant billing operations.
Overview
15
15
years of professional experience
Work History
Customer Service Rep. II
Baylor Scott & White Health
03.2018 - 09.2024
- Managed approximately 70 incoming calls, emails, and faxes daily from customers.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
- Supported the establishment of payment plans for patients struggling financially, demonstrating empathy while adhering to company guidelines on debt collection.
- Mitigated potential fraud risks by verifying patient information and conducting thorough background checks for eligibility verification purposes.
- Maintained detailed case files, facilitating easy retrieval of information for future reference or audits.
- Researched and resolved complex medical claims issues to support timely processing.
- Verified patient insurance coverage and benefits for medical claims.
- Reviewed provider coding information to report services and verify correctness.
- Followed up on denied claims to verify timely patient payment and resolution.
Customer Service Rep. III
Kelly Services (Cigna Health Spring & Baylor Scott & White)
Dallas, Texas
06.2017 - 03.2019
- Reduced claim denial rates with thorough reviews of medical records and accurate coding practices.
- Ensured compliance with industry regulations by staying up-to-date on changes in healthcare laws and guidelines.
- Collaborated with healthcare providers to resolve billing discrepancies, fostering positive relationships between parties involved.
- Was a reliable resource for team members by sharing expertise regarding the medical insurance field, facilitating mutual growth and development within the department.
- Assisted patients with understanding their benefits, coverage limitations, and financial responsibilities related to medical services received.
- Maintained detailed case files, facilitating easy retrieval of information for future reference or audits.
- Managed high call volume while maintaining accuracy and professionalism in documentation of interactions with customers.
Seasonal PSE Clerk
USPS
Fort Worth, Texas
08.2016 - 01.2017
- Enhanced customer satisfaction by efficiently sorting, routing, and distributing mail to appropriate destinations.
- Upheld a professional demeanor when interacting with customers, coworkers, and supervisors to maintain a positive work environment.
- Stayed current on USPS regulations and updates through regular attendance at training sessions or team meetings, applying new knowledge to daily tasks for continuous improvement in service quality.
- Ensured smooth operations through regular maintenance checks on postal equipment, reporting malfunctions promptly for quick resolution.
- Performed data entry tasks with high accuracy levels to ensure proper documentation of all incoming/outgoing parcels within the system.
- Accelerated processing times with effective use of automated equipment for mail sorting and distribution.
- Optimized time management skills while working under tight deadlines for daily dispatches of outgoing mail.
- Demonstrated adaptability when rotating between various tasks such as window clerk duties, bulk mail processing, or collection route coverage as needed.
- Sorted mail according to size, shape and destination.
- Moved bulk containers and large parcels with forklifts.
Education
Administrative Assistant Certificate - Administrative
Dallas Can Academy
Dallas, Texas07.1999
Diploma -
Nimitz High School
Irving, Texas06-1992
Skills
- Claims analysis
- Client relationship management
- Analytical reasoning
- Effective listening
- Proficient in ICD-10 coding
- Medicare/Medicaid
- Professional demeanor
- Insurance eligibility verification
- Effective conflict resolution
- Insurance claims processing
- Transaction management
Work Preference
Work Type
Full TimePart TimeWork Location
RemoteHybridOn-SiteImportant To Me
Career advancementHealthcare benefitsWork from home optionPersonal development programsCompany CultureWork-life balance401k matchStock Options / Equity / Profit SharingPaid time offPaid sick leaveFlexible work hoursQuote
The real test is not whether you avoid this failure, because you won’t. It’s whether you let it harden or shame you into inaction, or whether you learn from it; whether you choose to persevere.
Barack Obama
Software
Languages
English
Native or Bilingual
Timeline
Customer Service Rep. II
Baylor Scott & White Health
03.2018 - 09.2024
Customer Service Rep. III
Kelly Services (Cigna Health Spring & Baylor Scott & White)
06.2017 - 03.2019
Seasonal PSE Clerk
USPS
08.2016 - 01.2017
Administrative Assistant Certificate - Administrative
Dallas Can Academy
Diploma -
Nimitz High School
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