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clinic clerk ii customer service representative resume example with 6+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
  • :
Summary

Experienced, energetic, and goal-oriented professional seeking a position within the healthcare administration industry that could use an account manager, medical coding and billing specialist, or administration representative with exceptional knowledge of various coding and billing procedures.

Skills

  • Cross-functional collaboration
    Promotional support
    Business development understanding
    Transportation solution development
    Order documentation
    Inbound call management
    MS Office
    Adaptability
    Leadership Skills
    Computer Skills
    Communication Skills
    Medical Record Management
    Healthcare Administration
    Management
    Data Entry
    Integrated Reporting Information System (IRIS)
    Customer relations
    Business recovery and sustainability
    Data analysis and research
    Cost-benefit analysis
    Report writing
    Business process improvement
    10-key proficiency
    Project Management
    Data organization
    Data visualization
    Payroll processing
    Report generation
    SQL
    Tableau
    Business Consulting
    MS Office
    Communication skills
    Customer service
    Office experience
    QuickBooks
    Account reconciliation
    ICD-9/10
    Medical Billing/Coding
    Scheduling
    Referral Coding/Review
Experience
Clinic Clerk II/Customer Service Representative, 12/2022 - Current
Kaiser Permanente Los Angeles, CA,
  • Processed customer exchanges, refunds and bill adjustments to correct product or service problems.
  • Kept records of customer interactions or transactions, recording details of inquiries and actions taken.
  • Updated records with details of customer interactions and transactions.
  • Checking-in patients, verifying patient information Scheduling appointments.
  • Updating Electronic Health records by way of EPIC and Oracle systems.
  • Facilitating intake procedures Preparing and completing accurate, job-related documentation, including collecting, updating, and maintaining patient medical and insurance information
  • Collecting payments for services
  • Inbound/Outbound calls to doctors and patients for scheduling instructions
  • Research referrals and either deny or approve based on information obtain and appropriately identify diagnosis (CPT and ICD-9 coding)
Billing/Customer Service Representative, 06/2021 - 12/2021
Sedona Staffing City, STATE,
  • Obtaining recommendations and pre-authorizations for treatments as needed.
  • Examining eligibility and verifying benefits for treatments, hospitalization, and procedures.
  • Utilizing billing software (Kareo Billing and MBE), to prepare, evaluate, and send claims, including electronic and paper claim processing.
  • Informed customers of promotions and special offers to increase sales.
  • Customer Service inbound and outbound calls
  • Processing specific program related enrollment forms
  • Processing specialty medication triage requests
  • Managing insurance claims, invoices, and payments
  • Coding services, procedures, diagnoses, and treatments (ICD-9, ICD-10 coding)
  • Billing and processing related to patient co- payment assistance programs and prior authorizations requests.
  • Discuss medications, insurance and prior authorization documents with patients.
  • Get prior authorization approval from insurance firms and nurse managers.
  • Follow up on missing or incorrect information so patients receive the right reimbursement.
Business Analyst/ Consultant, 07/2019 - 09/2020
Kaiser Permanente City, STATE,
  • Collaborated with project sponsors to determine project scope and vision.
  • Evaluated trends to assess strategies and understand competitive environments.
  • Conducting inbound/outbound calls to patients, healthcare facilities, patients, etc.
  • Processed member records and prospective enrollment applications within the Medicare department
  • Reconciled historic records and payment variances.
  • Oracle Database documentation/processing
  • Identified key growth and contribution opportunities for business through data research and analysis.
  • Reconciled and reported record discrepancies to prepare for annual audits.
  • Analyzing and evaluating the current business processes a company has and identifying areas of improvement.
  • Conducting data analysis as well as analyzing claims, enrollment, and general health insurance data
Account Administrative Representative, 12/2014 - 07/2019
Kaiser Permanente City, STATE,
  • Recorded, stored and analyzed information using accounting software.
  • Determining eligibility requirements have been met for enrollment purposes
  • Performed administrative and office duties, including phone and email correspondence, ordering materials and bookkeeping
  • Customer Service inbound and outbound calls
  • Managing insurance claims, invoices, and payments
  • Coding services, procedures, diagnoses, and treatments (ICD-9, ICD-10 coding)
  • Billing and processing related to patient co- payment assistance programs and prior authorizations requests
  • Conducting data analysis as well as analyzing claims, enrollment, and general health insurance data
  • within the Medicare department
  • Reconciled historic records and variances •
  • Identified key growth and contribution opportunities for business through data research and analysis
  • Reconciled and reported record discrepancies to prepare for annual audits
  • Pinpointed inefficiencies in business processes and recommended improved policies
Education and Training
High School Diploma: , Expected in 12/2007
-
Garfield Senior High School - San Diego,
GPA:
Status -
Associate of Arts: Business Administration And Management, Expected in
-
Southwestern College - Chula Vista, CA,
GPA:
Status -
CPC/CMC: Medical Insurance Billing, Expected in
-
University of Phoenix - Tempe, AZ
GPA:
Status -

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Resume Overview

School Attended

  • Garfield Senior High School
  • Southwestern College
  • University of Phoenix

Job Titles Held:

  • Clinic Clerk II/Customer Service Representative
  • Billing/Customer Service Representative
  • Business Analyst/ Consultant
  • Account Administrative Representative

Degrees

  • High School Diploma
  • Associate of Arts
  • CPC/CMC

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