Enthusiastic self-starter with over seven years of performing clerical and secretarial tasks using exceptional communication and customer service acumen. Proven academic and professional achiever who possesses unique computer skills required to assist the executives and organization to achieve its mission. An expert communicator who is known for multitasking and completion of multiple assigned tasks within deadline.
08/2013 to 09/2016
Associated Customer Service SpecialistAetna Life Insurance Company LLC － Houston, Texas
Assist insurance benefits members with their associated medical, dental and vision plan coverage.
Assigned members to specific primary care providers as well as providing health education to members.
Complete scheduling for office visits for all members.
Research ongoing eligibility on behalf of the member with the state benefit office to help members maintain their benefits.
Assisting with reviewing claims for the services provided submitted and processed to Aetna/Coventry.
Advised health care providers of ICD-9, CPT, HCPCS and CMS coding manual coverage for the plan.
As well as advising if the services are covered and able to be rendered by the provider.
Review of remittance device (payments) with providers to concluded the balance.
Forwarding imagines of claims to designated departments from providers to process and review the CMS1500/ EDI/ UB (hospital) claims and medical records of patient/members for appropriate processing of the claim.
09/2010 to 07/2013
Senior Collections Specialist /Customer Service RepresentativeUnited Recovery Systems LLC － Houston, Texas
To identify when delinquent accounts need to be called based on their terms of sale and call promptly once an account becomes past due.
Follow up frequently to ensure payment commitments are met.
Provide detailed information in the on line credit notes.
Handle all requests for documentation and to conduct all research resulting from the morning calls in the afternoon.
Reconcile at least one disputed account per day.
Provide superior customer service to our internal and our external customers.
Inform sales representatives of significant changes in account status in a timely and professional manner.
Compile and submit information about problem accounts to the Department Manager.
Collections of 1st & 3rd party accounts (credit cards), maintain Monthly desk budget, oversee monthly accounts ranging from $100 dollars to $45K.
Assist team members when they have escalated calls and need Team Lead assistance.
02/2009 to 09/2010
Customer Service Representative/ Benefits SpecialistHealth Help/ First Health － Houston, Texas
Contacts insurance company to verify patient coverage and obtain information concerning extent of benefits, via phone, website or fax.
Verify insurance information and benefits on all new patients, and on any patient with new insurance.
Follow -up with patient for additional information if it's needed.
Verify referral status and follows up with patient or PCP to verify that referral has been made if required.
Prepares new patient paperwork and any updates on existing patients.
Attach all paperwork including a check list of what is needed and place in an alphabetized file for the front desk.
Prepares same day add-on patient paperwork.
Ensures all benefits are posted appropriately to the patients account as directed in the revenue cycle.
Communicate with PAR's and front desk regarding needed information for the provider's clinic.
Indicate the patient's financial responsibility by highlighting deductible, co-pays or co-insurance on the super bill and enters the copay amounts in the information system (IDX) as required.
02/2007 to 02/2009
Customer Service Representative/ HR AssistantXerox － Houston, Texas
Answering Incoming customer phone inquiries.
Discuss billing and technical issues providing resolutions to all problems.
Taking payments over the phone.
Deal with large business accounts.
Process Team Time off request, LOA, and termination.
Work with HR to verify Background and Drug Screens.
Partner with HR to process pay increases for employees.
Initiate and educate contractors on verbal and written warnings.
Process Terminations for employees.
Daily use of Compass, Iconnect, SView, and Outlook.
As a Supervisor manage a large group of agents, answer all inquiries and cater to individual needs Ensure individual agents meet monthly and weekly goals set per month.
Certificate: Medical AssistantRoss Medical Education Center － Grand Rapids, Texas