Tonya Bourne
Houston,TX
Summary
Dedicated Customer Service Specialist providing skills to prioritize and multi-task in fast-paced working environment. Successfully works as part of team to reach personal and business goals. Known for successfully handling escalated customer support issues.
Overview
17
17
years of professional experience
Work History
Customer Service Representative
All Web Leads
Austin, TX
06.2022 - Current
- Answered inbound calls, chats and emails to facilitate customer service.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
- Asked probing questions and offered solutions to resolve customer issues.
- Answered insurance-related questions and discussed product offerings with prospective customers to meet unique needs.
Patient Account Specialist
Xtend Healthcare
90 Volunteer Dr #200, TN
07.2021 - Current
- Reached out to patients once insurance was billed in order to obtain payments due.
- Submitted electronic bills following facility and legal compliance standards.
- Maintained up-to-date understanding of insurance payment practices.
- Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Created and sent time of service letter to inform patient of estimated self-pay balance.
- Accessed third-party insurance databases to identify coverage of benefits.
- Determined estimated self-pay portion by calculating charges, co-insurance and deductibles.
Patient Account Representative
CCRM Houston
Houston, TX
05.2020 - 07.2021
- Reached out to patients once insurance was billed in order to obtain payments due.
- Organized and maintained office supplies to promote team productivity.
- Submitted electronic bills following facility and legal compliance standards.
- Processed refunds, disbursements and payments.
- Collaborated with relevant parties to resolve billing issues, insurance claims and patient payments.
- Generated detailed reports outlining billing, flagged items and other important data.
- Resolved inquiries from patients, families and external payers.
- Compared statements against patient files.
- Accepted and processed customer payments and applied toward account balances.
- Worked closely with delinquent account holders to collect and reconcile accounts through approved channels.
- Investigated billing discrepancies and implemented effective solutions to resolve concerns and prevent future problems.
- Answered customer questions regarding account discrepancies or problems.
Customer Service Support Representative
Acclara Solutions
Houston, TX
07.2017 - 05.2020
- Assisted in training and motivating new employees.
- Asked probing questions to determine service needs and accurately input information into electronic systems.
- Consulted with customers to resolve service and billing issues.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Made outbound calls to obtain account information.
- Answered inbound calls, chats and emails to facilitate customer service.
- Demonstrated excellent communication skills in resolving product and consumer complaints.
Medical Biller
Elite Surgical Affiliates
Houston, TX
03.2014 - 06.2017
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Organized information for past-due accounts and transferred to collection agency.
- Completed and submitted appeals for denied claims.
- Interpreted medical terminology and pharmacological information to translate information into coding system.
- Leveraged EMR software to post payments received for medical services.
- Monitored reimbursement from managed care networks and insurance carriers to verify consistency with contract rates.
- Applied HIPAA privacy and security regulations while handling patient information.
- Communicated with insurance representatives to complete claims processing or resolve problem claims.
- Processed invoice payments and recorded information in account database.
- Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
Medical Billing Specialist
north jackson medical center
Jackson, MS
03.2007 - 12.2012
- Prepared billing statements for patients, ensuring correct diagnostic coding.
- Reviewed and verified benefits and eligibility with speed and precision.
- Maintained current working knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third-party billing requirements.
- Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.
- Contacted insurance providers to verify insurance information and obtain billing authorization.
- Applied payments, adjustments and denials into medical manager system.
- Precisely completed appropriate paperwork and system entry regarding claims.
- Entered procedure codes, diagnosis codes and patient information into [Nextgen].
- Reviewed patients' insurance coverage, deductibles, possible insurance carrier payments and remaining balances not covered under policies.
- Consistently informed patients of financial responsibilities prior to services being rendered.
- Completed appeals and filed and submitted claims.
Education
Associate of Science - Medical Office Management
Virgina College
Jackson, MS06-2007
Skills
- Data Entry
- Medical terminology knowledge
- Product Knowledge
- Inbound and Outbound Calling
- Account updating
- Appointment Scheduling
- Typing 35 WPM
- Credit card payment processing
- Multi-Task Management
- Microsoft Excel
- Problem-solving abilities
- High-energy attitude
- Insurance claims management
- Customer Billing
- Billing Procedures
Technology Summary
MS Office (word, excel, outlook), Nextgen, Advantax, Xifin, Zirmed, Adobe, Acrobat Pro DC, Cubs, Epic, Webmail, Mychart, Citrix, Centricity, Doc
Timeline
Customer Service Representative
All Web Leads
06.2022 - Current
Patient Account Specialist
Xtend Healthcare
07.2021 - Current
Patient Account Representative
CCRM Houston
05.2020 - 07.2021
Customer Service Support Representative
Acclara Solutions
07.2017 - 05.2020
Medical Biller
Elite Surgical Affiliates
03.2014 - 06.2017
Medical Billing Specialist
north jackson medical center
03.2007 - 12.2012
Associate of Science - Medical Office Management
Virgina College
Similar Profiles
Damien MillerDamien Miller
Property & Casualty Insurance Agent at All Web LeadsProperty & Casualty Insurance Agent at All Web Leads
Flor SANDOVALFlor SANDOVAL
Customer Service Representative at All Web LeadsCustomer Service Representative at All Web Leads
Amanda KirkendollAmanda Kirkendoll
Insurance Sales Representative at All Web LeadsInsurance Sales Representative at All Web Leads