Secure
a position with a successful , growing company or established corporation that
requires a highly motivate and committed individual with extensive computer
skills and desire to innovate. Seeking a position with career growth potential.
Skill Highlights
Skillful customer service experience, Multi-Task Management, Data entry, Telephone Skills, Research, Team player, Self-motivated, Money collection and posting, Managing Physician Schedules and Scheduling for Multiple Specialties
Computer
proficient in Microsoft; Word, Excel, Outlook, Insurance verification,
Authorization/ Referral Requesting, Medical Terminology knowledge, ICD-9,
CPT and HCPCS knowledge
Work Experience
Ambulatory Service Representative II, 2014 - Current Kelsey Seybold Clinic – Pearland, TX,
Check in and check out patients
Communicate with patient, staff and providers regarding patient arrivals, delays and clinic processes
Verify patient insurance benefits, request authorizations and/or referral prior to the patients' appointments.
Register patients in Epic and make sure that all the patients' demographic information is entered accurately.
Respond to customer questions and /or service related to appointment status, wait time, or unanticipated problems
Answer all incoming calls, schedule new or follow up appointments
Preform outbound calls to confirm, schedule and/or cancel appointments.
Create estimates for patient responsibility prior to office visits or testing and notify patients of any amount due.
Collect co-payments, co-insurance and/or self-pay amounts using Skipjack Enter batches and reconciles TCH charges
Ensure that interpreter services are available for patients as needed
Manage Epic inbasket, email and rightfax requests
Perform master scheduler duties; create, open and close the Physicians' schedules
Perform other duties and provide basic office support including ordering and maintaining office/clinic supplies; maintaining office equipment; managing correspondence; copying, faxing, mailing and filing documents; and collecting and distributing mail.
Supervisor, 04/2013 - 2014 Ucla Health – North Hollywood, CA,
Supervise the day-to-day operations of the Member Services Department.
Monitor daily telephone activities via RTA (Real Time Adherence) and Interaction Supervisor systems.
Review all daily reports to manage team productions, workloads and trends.
Responsible for training staff's assignments to ensure compliance requirements.
Coach and provide career development guidance to staff.
Observe and evaluate employee goals (weekly, monthly, and quarterly) and conduct employee performance reviews.
Coordinate with senior management and Human Resources for appropriate staffing levels and disciplinary actions.
Assign and ensure that all direct reports participate in the Online Learning System and mandatory trainings.
Monitor random calls to improve quality, minimize errors and track operative performance.
Participate and conduct formal/informal team meetings and 'one-on- one' sessions with upper management.
Responsible for scheduling staff.
Senior Lead Member Service Representative, 05/2009 - 04/2013 Gcs Credit Union – Pontoon Beach, IL,
Assisted member services representatives with daily issues Served as first line responder to escalated calls and followed-up on resolutions Entered medications overrides and member updates in the system Monitored the Queue throughout the day Handled and resolve customer complaints Provided coaching to staff requiring further assistance Handled all assigned duties or request by supervisor in a timely manner Assisted in the development of new procedures.
Member Service Representative, 09/2006 - 05/2009 HF Management Inc – City, STATE,
Answered incoming calls.
Documented and responded to all members inquiries about the plan benefits, policies and procedures.
Investigated and resolve member claims, complaints and concerns.
Maintained the member's records by updating accounts requested by the member.
Educational Background
: Medical Billing and Coding, Expected in 03/2012 - Ultimate Medical Academy - Tampa, FL GPA: Medical Billing and Coding
High School Diploma: , Expected in 05/2004 - Superior Casaiano Cepeda - Rio Grande, PR GPA:
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