Livecareer-Resume
Jessica Claire
  • , , 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Professional Summary

Customer service oriented, professional who provides timely and accurate data to ensure reimbursement for patient and provider services. Follows policies, procedures, and guidelines to assure consistent quality. Maintains and ensures patient privacy and confidentiality.

Skills
  • Strong written, verbal, and interpersonal skills for effective communication and documents
  • Well organized and experienced with Microsoft Word
  • Ability to work under pressure
  • Conflict resolution
  • Data Analysis
  • Integrity and ethics
  • Time management and efficiency
  • Extensive knowledge of commercial medical Insurance, Pharmacy Benefits, CPA Programs ETC.
  • Knowledge on Government funded Insurances (Medicare, Medicaid, TRICARE, ETC.)
  • Adaptability, capable of working in constant change in workplace
Work History
Care Coordinator, 02/2020 to Current
Northern Arizona HealthcareCamp Verde, AZ,
  • Administrator for internal website
  • Serve as an expert on reimbursement, co-pay, foundation assistance and PAP issues and be responsible for handling patient and healthcare provider interactions
  • Serves as direct point of contact to assigned health care providers for ongoing support and relationship
    development by acquiring and delivering detailed information regarding a program and/or a patient
  • Partner with the prescriber and patient to remove all non-clinical barriers to patient access to prescribed
    therapy
  • Knowledge and understanding of the different types of major payers including private/commercial and
    government (Medicare, Medicaid, VA and DOD). Act as an assigned liaison to client contacts (e.g.
    regional contact for sales representatives)
  • Maintains records in accordance with applicable standards and regulations to the programs/promotions
  • Establish relationships, develop trust, and maintain rapport with patients and healthcare providers
  • Follow program guidelines and escalate complex cases according to program policy and procedures
  • Liaison between Program Management, Healthcare Providers and Manufacturer
  • Provides unparalleled customer service while serving as a brand advocate and program representative;
    understands the importance of achieving quality outcomes and commit to the appropriate use of
    resources
  • Works with the Franchise Program Manager, and Client on a day-to-day
    basis to maintain open lines of communication and share awareness regarding patient status, prescriber
    feedback/satisfaction and program effectiveness
    • Improve patient outcomes through advocacy, communication, education and facilitation of services
  • Understand health and disease states of patients of the programs/promotions
    • Maintains a high level of ethical conduct regarding confidentiality and privacy
  • Conflict Resolution
Reimbursement Specialist, 11/2019 to 02/2020
Francisan HealthTinley Park, IL,
  • Keep abreast of payer trends and policies.
  • Ability to understand and explain benefits offered by all payer types including private/commercial and government (i.e., Medicare, Medicaid, VA and DOD).
  • Working case management system, documenting status/background in case notes, communicating patient benefits, assisting in the PA process and like responsibilities.
  • Responsible for insurance benefit investigations, and triage cases according to program standard operating procedures.
Customer Service Representative, 01/2018 to 01/2019
Parker's Convenience StoresMonck's Corner, SC,
  • Provided primary customer support to internal and external customers in fast-paced environment.
  • Performed data entry, managed heavy telephone work, and provided high quality customer service in a call center setting.
  • Offered advice and assistance to customers, paying attention to special needs or wants.
  • Answered customer telephone calls promptly to avoid on-hold wait times.
  • Responded to customer requests for products, services and company information.
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
Customer Service Representative, 11/2015 to 11/2016
Parker's Convenience StoresHardeeville, SC,
  • Performed data entry, managed heavy telephone work, and provided high quality customer service in a call center setting.
  • Acted as the direct point of contact for customers.
  • Maintained a high level of confidentiality while accessing customer accounts.
  • Effectively communicated all information with customers.
  • Brought finely tuned attention to detail and commitment to quality to all assigned tasks.
  • Serve as a resource for patients and healthcare professionals to verify insurance coverage, medical billing, reimbursement process, and general access for complex pharmaceuticals.
  • Evaluate program enrollment forms for data integrity.
  • Ability to understand and explain benefits offered by all payer types including private/commercial and government (i.e., Medicare, Medicaid, VA and DOD).
  • Keep abreast of payer trends and policies.
  • Follow program guidelines and escalate complex cases according to program policy and procedures.
Education
Associate of Science/Health Sciences Degree: Health Sciences, Expected in 10/2018
Ultimate Medical Academy - Clearwater, FL,
GPA:

Fully accredited, accelerated program providing instruction in medical administrative and general office procedures, transcription, medical records management and reimbursement methodologies including revenue cycle management. Program content emphasizes medical billing procedures, basic procedural and diagnostic coding systems, collections procedures and accounting functions essential to the medical environment. Research, professional writing, critical thinking and communications skills are developed throughout the program.

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

Disclaimer

Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.

How this resume score
could be improved?

Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:

92Good

resume Strength

  • Formatting
  • Length
  • Personalization
  • Strong Summary
  • Target Job
  • Typos

Resume Overview

School Attended

  • Ultimate Medical Academy

Job Titles Held:

  • Care Coordinator
  • Reimbursement Specialist
  • Customer Service Representative
  • Customer Service Representative

Degrees

  • Associate of Science/Health Sciences Degree

By clicking Customize This Resume, you agree to our Terms of Use and Privacy Policy

*As seen in: