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Cost Authorization Agent Resume Example

Resume Score: 80%

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COST AUTHORIZATION AGENT
Professional Summary

Highly motivated, very strong willed and driven. Technically-savvy with outstanding relationship building,
training and presentation skills. Excellent at juggling multiple tasks and working under pressure. Multiple
areas of expertise.

Skills
  • Attention to detail
  • Filling and data archiving
  • Intermediate Excel spreadsheet functions
  • Professional and Superior organizational
    skills
  • Behavioral & medical health billing, and
    collections
  • Hospital inpatient and outpatient records
  • HIPPA Compliance Articulate and well-spoken
  • Microsoft Office & Outlook
  • Proficient Pleasant demeanor
Work History
Cost Authorization AgentSep 2020 - Current
Company NameCity, State

· Handle a high volume of calls from field contractors requesting approvals for repair costs associated with pending service orders

· Review and approve job costs for Emergency Recruit Contractors and jobs with special circumstances not identified or pre-negotiated on rate sheets

· Accurately document conversations, agreements, and actions taken with contractors regarding job costs and tasksProactively communicate with customers to advise of claim status to meet KPI's

· Build excellent customer and contractor relationships during every interaction

· Ensure and verify accuracy of job creation, job coding, and job details from creation to completion

· Promptly respond to diary actions generated by other team members or contractors

· Proactively contacting customers or contractors to update Work-in-Progress service orders

· Act as a subject matter expert for Repair Management regarding residential repair terminology and techniques

· Stay up to date with local codes, regulations, and labor and material costs

Billing SpecialistOct 2017 - Current
Company NameCity, State
  • Establishes and maintains professional and effective relationships with peers and other stakeholders
  • Establishes and maintains a professional relationship with clinics and FMG staff in order to resolve issues
  • Reviews and posts payments and write-off/adjustments from insurance and patients
  • Explanation of Benefits (EOBs)/ Electronic Remittance Advice (Eras), payments, adjustments, insurance insurance
    contracts and contracting system, insurance benefits, and all account comments; applies knowledge of payer contracts and experience with insurance reviews to gather additional information as necessary
  • Posts and tracks electronic funds transfer (EFT) information and validates EFTs for accuracy
  • Follows write-off approval protocols for non-routine adjustments. Completes daily posting log and quarterly cash
    handling audits and reports findings to Supervisor
  • Applies current knowledge of government/commercial insurance reimbursement terms, contractual
    and/or other adjustments and remittance advice details
SCD Customer Service RepJul 2014 - Oct 2017
Company NameCity, State

Professionally handle incoming telephone calls from Internal and External customers
Explain EOB's (Explanation of Benefits) to members based on questions asked

Posted payments to member accounts from statements received
Enter telephone inquiry report of contact into customer service intake screen
Maintain telephone performance goals established by the specified division
Manage personal route list daily
Provide the same high quality service to “walk-in” inquiries that is provided for telephone inquiries
Work with all departments in the division or company to resolve customer service inquiry issues
Attend available training sessions to further enhance skills
Ensure timely and accurate completion of daily/weekly telephone reports
Stay up-to-date regarding online resources, such as Online Help, BlueAlert, Medical Policy, and all other electronic resource changes when applicable
Processed claims

Registrar/PBX Phone OperatorApr 2014 - Jul 2015
Company NameCity, State

Receive and direct all incoming calls to the appropriate party, in a timely and professional manner.
Interview patients at workstation or at bedside to obtain all necessary account information. Bed-side
registration performed utilizing carts/computers on wheels
Coordinates with business office meal ticket monies, safe entries and removals, mail distribution, and
vehicle sign ins/outs.
Calculate and collect patient liability amounts
Verify insurance benefits and determines pre-certification/authorization status via on-line or other
resources. If pre-certification/authorization/notification of admission is required and has not been
obtained, initiate via Passport, on-line or phone call. - Enter all information and authorization/referral
numbers into the registration system
Interview incoming patients, his/her relatives, or other responsible individuals to obtain identifying and
demographical information with insurance and financial information
Assign Insurance Plans (IPlans) accurately
Search MPI completely and assign the correct medical record number. Notify HIM for any duplicate unit
numbers

Education
High School Diploma2005
Brainerd High SchoolCity, State
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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.

Resume Overview

School Attended

  • Brainerd High School

Job Titles Held:

  • Cost Authorization Agent
  • Billing Specialist
  • SCD Customer Service Rep
  • Registrar/PBX Phone Operator

Degrees

  • High School Diploma 2005

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