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Billing and Audit Representative Resume Example

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BILLING AND AUDIT REPRESENTATIVE
Career Overview
   Dedicated, reliable and motivated professional who is a hard-worker with exceptional communication and organizational skills who strives to become more productive by learning and applying my knowledge and experience.
​
Core Strengths
  • Strong organizational skills
  • Active listening skills
  • Customer service expert
​​
  • Seasoned in conflict resolution
  • Sharp problem solver
  • Adaptive team player
​​
Accomplishments
Customer Service
  • Nominated as a 4-Time "World Class Performer" with United Parcel Service.
  • Researched, calmed and rapidly resolved client conflicts to prevent loss of key accounts.​
Quality Communication
  • Interacted with 350 Medicaid/Medicare members to gather current health care data and encourage individuals and family members to address their health concerns and adhere to health care guidelines.
Customer Assistance
  • A multitude of past experience working with companies and clients in a variety of capacities to provide customer satisfaction and diligently completing all tasks assigned, going above and beyond and working overtime as needed.
Member Engagement
  • Heavily complimented on a 12 year span of greeting YMCA customers upon entrance and handling membership verification, member requests and all other customer service duties assigned. ​​
Work Experience
Billing and Audit Representative
August 2016 to Current
A Helping Hand Homecare - Myrtle Beach , SC

Special project auditing claims and investigating billing discrepancies in the system data to provide accurate reports used in the analysis of drug testing.

    ​
      Care Coordinator
      April 2014 to May 2016
      Lutheran Social Services Of Wisconsin And Upper Michigan Inc - West Allis , WI

      Responsible for telephonic outreach to Medicaid/Medicare Special Needs Population (SNP) members in gaining access to community-based support services through integration of medical and long term care (LTC) services pertaining to orientation, care plan development, completion of assessments and care coordination.

      ​

      Assuring quality services are provided as part of an interdisciplinary team approach to problem solve and support health and create behavioral change while adhering to HIPPA policies to maintain client confidentiality.

      ​

      Collaborate with discharge planners, physicians, and other health care professionals to ensure appropriate discharge planning, care planning, and coordination of acute care and long term care services that meet the member's needs.

      ​

      Adhere to health care guidelines set forth by the Centers for Medicaid/Medicare Services (CMS).​ 

       ​
      Iris Consultant
      January 2012 to April 2014
      City Of Doral - Doral , FL

      Responsible for assisting Medicaid/Medicare participants to create and establish a self-directed Long-Term Care (LTC) care plan while identifying and implementing care plan outcomes using a community-based network of resources and informal or voluntary services and supports.

      ​​
      Building Director
      August 2009 to September 2015
      Troon Golf, L.L.C. - Aurora , CO

      Supervisory position responsible for organizing and overseeing athletic and recreation programs for Milwaukee Public Schools and adaptive sports and recreation programming.

      ​

      Actively worked with recruitment and training of volunteer staff and evaluating programs for effectiveness of meeting the participants needs.

      ​​
      Member Services Attendant
      May 2002 to October 2013
      Southwest YMCA - City , STATE

      Customer Service position responsible for being the first point of contact engaging with Members to ensure customer safety and satisfaction by verifying current membership status, addressing all requests, answering questions, and other customer-focused duties associated with YMCA programs, policies, and procedures.

      ​​
      Preferred Customer Associate
      July 1995 to September 2001
      United Parcel Service - City , STATE

      Business Development position working directly with National and International accounts, Account Executives, High-Volume clients and other company personnel to meet the customers needs in the daily maintenance of domestic and worldwide shipping and receiving.

      Increased sales volume and revenue of over 130 Preferred and National accounts.​
      ​
      Educational Background
      Bachelor of Science : Social Work, 2010University of Wisconsin - Helen Bader School of Social Welfare - City, State
      Fieldwork Experience- Unlimited Potential - Alcohol and Other Drug Abuse (AODA) Treatment Facility. Assisted Substance Abuse Counselors and clients with facilitating meetings and drug testing.
      ​
      ​Minor Degree - ​American Sign Language/ASL Studies
      ​
      Skills

      • Computer software using Windows XP, 8, 10, Word, Excel, PowerPoint, PDF Files, etc.
      • Auditing, Billing, Customer Service/Customer Support, and Business Development.
      • Organizing, Programming, Research,  Recruitment, Supervisory, and Quality control.
      • Caseload management, Long-term care, Medicaid regulations, Medical and clinical services, HIPAA compliance.
      • Extensive public speaking experience and serves as guest speaker for the Victim Impact Panel and Juvenile Accountability Panel for Wisconsin Community Services, 2005-Present.
      • Experience using Motivational Interviewing (MI) skills for the Mediation and Restorative Justice Center and served as Victim/Offender Mediation Facilitator.
      • CPR/AED Certification
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      How this resume score could be improved?

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      77Average
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      Resume Overview

      School Attended

      • University of Wisconsin - Helen Bader School of Social Welfare

      Job Titles Held:

      • Billing and Audit Representative
      • Care Coordinator
      • Iris Consultant
      • Building Director
      • Member Services Attendant
      • Preferred Customer Associate

      Degrees

      • Bachelor of Science : Social Work , 2010

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