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Access Service Representative II Resume Example

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VT
ACCESS SERVICE REPRESENTATIVE II
Professional Summary

Helpful Patient Service Representative with 10+ years of experience. Adept at collecting patient information, maintaining efficient office and coordinating with medical professionals. Extensive knowledge of insurance authorizations and commitment to patient happiness.

Work History
Company Name - Access Service Representative IICity, State04/09/2 - Current
  • Attended weekly facility meetings to discuss logistical issues and obtain updated procedural and insurance-related instructions.
  • Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
  • Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
  • Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
  • Resolved patient financial and authorization/referral problems with guidance from documented guidelines and procedures.
  • Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
  • Explained estimated cost for medical treatments and answered patient questions to promote good understanding of proposed services.
  • Received patient deductibles, co-pay amounts and self pay estimates and discussed options to satisfy remainder of patient financial obligations.
  • Contributed to reduction of accounts receivables by adhering to predetermined policies and procedures to recover amounts due from patients.
  • Determined patient financial needs and referred eligible patients to proper county, state or federal agencies to obtain financial assistance.
  • Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
  • Took copayments and compiled daily financial records.
  • Reviewed and corrected claim errors to facilitate smooth processing.
  • Balanced deposits and credit card payments each day.
  • Generated monthly statements to check outstanding balances.
  • Explained plans for treatment and payment options.
  • Initiated Inpatient, Outpatient, Observation authorizations.
Company Name - Emergency Room RegistrarCity, State04/2008 - Current
  • Carried out front office duties utilizing data entry skills in framework of medical database.
  • Completed skilled administrative work to support all office staff and operational requirements.
  • Organized paperwork such as charts and reports for office and patient needs.
  • Completed and filed financial documentation for accounting purposes.
  • Verified, linked and loaded patients insurance.
  • Initiated Er to Inpatient authorizations with insurance companies.
Company Name - Medicare Billing SpecialistCity, State10/2001 - 10/2006
  • Reviewed patient records, identified medical codes and created invoices for billing purposes.
  • Liaised between patients, insurance companies and billing office.
  • Adhered to established standards to safeguard all patients' health information.
  • Translated and interpreted medical billing codes with strong accuracy to enable swift payment from insurance agencies.
  • Participated in workshops and other training opportunities to remain current on billing procedures, regulations and industry updates.
  • Reviewed services rendered and completed to reconcile codes.
  • Communicated with insurance providers to resolve any denied claims and resubmit.
  • Submitted electronic and paper claims to insurance companies including Medicare and Medicaid to collect medical payments.
  • Reviewed patient diagnosis codes to verify accuracy and completeness.
  • Posted payments and collections on regular basis.
  • Researched and followed up on denied insurance claims.
  • Verified proper ICD-9 coding on claims.
  • Reviewed outgoing bills for eligibility and accurateness.
  • Completed client requests and advised supervisors of special needs.
  • Trained new employees on multiple medical billing programs and data entry software.
  • Transferred balances to correct payers.
Skills
  • Administrative and Office Support
  • Providing Information and Resources
  • Helpful and Service-Oriented
  • Explaining Policy and Procedures
  • Resolving Problems
  • Microsoft Office
  • Database Search and Data Entry Skills
  • Registration and Scheduling
  • Building Rapport and Credibility
  • Gathering Information from Patients
  • Calm and Effective Under Pressure
  • Patient Needs Assessment and Referral
  • Patient Confidentiality and Data Security
  • Quality Standards and Protocols
  • Communicating to Patients and Families
  • Caring and Empathetic
  • Verbal and Written Communication
  • Organized and Efficient
  • Documenting and Recording Information
  • Comfort with Technology and Databases
  • Spreadsheet Tracking
  • 50 WPM Typing Speed
  • Clerical and Filing Support
  • Medical Services Administration
  • Multi-Line Telephone Systems
  • Records Management
  • Professional Bedside Manner
  • Collections Management
  • Reliability and Dedication
  • Attention to Detail
  • Technical Troubleshooting
  • Claims Handling and Coverage Verification
  • Time Management and Prioritization
  • Medical Terminology
  • Forms and Spreadsheet Creation
  • Payment Calculation
  • Spanish Fluency
  • Outbound Calling
  • Satisfaction Assessment and Tracking
  • Report Preparation
  • Punctual and Hardworking
  • Conflict Resolution
  • HCPCS Compliance
  • Insurance Authorizations
  • Benefits Explanation
  • Bilingual Spanish and English
  • Patient Registration
  • Insurance Forms Processing
  • Vital Statistics Documentation
  • Safety Monitoring
  • Word Processing
Education
05/2020
Austin Community College
City, State
Certificate: Medical Coding And Billing
04/1996
Plainview High School
City, State
High School Diploma
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Resume Overview

School Attended

  • Austin Community College
  • Plainview High School

Job Titles Held:

  • Access Service Representative II
  • Emergency Room Registrar
  • Medicare Billing Specialist

Degrees

  • Certificate : Medical Coding And Billing
    High School Diploma

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