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Crisis Counselor (Volunteer) Resume Example

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CRISIS COUNSELOR (VOLUNTEER)
Professional Summary

Efficient and hardworking Specialist bringing 5+ years of experience meeting clients' needs via telecommuting roles with solid background proactively managing claims and preventing insurance issues. Competent in keeping records accurate and current and proactively managing account problems. Excellent customer relations skills combined with an analytical approach to handling routine and complex delays.

By meeting productivity targets and maintaining current knowledge of company offerings. Offering empathy, reliability and enthusiasm for satisfying clients.

Skills
  • Customer Service
  • Insurance Knowledge
  • Medical Records/Documentation
  • Eligibility Verification
  • Goal Setting
  • Crisis Intervention
  • Reflective Listening
  • MS Office proficient
  • Quality Assurance
  • Data Entry
  • Prior authorization processing
Work History
Crisis Counselor (Volunteer), 08/2018 to Current
Crisis Text Line – City , STATE
  • Handled live chats with 3+ individuals in crisis that texted hotline for assistance in one setting
  • Used skills such as active listening and collaborative problem-solving daily to connect with patients and address concerns
  • Evaluated risk towards client or others by gathering information and conducting assessments
  • Built safety plans to lower overall risk of crisis and intervened in specific manners outlined by procedures
  • Provided comprehensive case management services, including creating treatment plans and connecting clients and families to appropriate resources
Reimbursement Counselor, 10/2013 to 07/2015
AmerisourceBergen – City , STATE
  • Collects and reviews all patient insurance benefit information, authorized by Sanofi's guidelines of patient assistance program.
  • Researches and resolves 50+ claim denials or underpayment of claims.
  • Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods.
  • Provides exceptional customer service to internal and external customers; resolves any customer requests within timely and accurate manner; escalates complaints accordingly.
  • Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers.
  • Reports any reimbursement trends/delays to thesupervisor (e.g. Billing denials, claim denials, pricing errors, payments, etc.).
  • Processes any necessary insurance/patient correspondence.
  • Provides all necessary documentation required to expedite payments.
  • This includes demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians.
  • Coordinates with inter-departmental associates to obtain appropriate medical records relatingto reimbursement process.
  • Maintained Health Insurance Portability and Accountability Act (HIPPA) in regards to patient account status and financial affairs of clinic/corporation.
  • Communicates effectively to payers and/or claims clearinghouse to ensure accurate and timely electronically filed claims.
  • Works on problem solving of moderate scope where analysis of data requiring review of variety of factors.
  • Exercises judgment within defined standard operating procedures to determine appropriate action.
Patient Case Coordinator, 01/2012 to 10/2013
AmerisourceBergen – City , STATE
  • Handle inbound calls from Health Care Providers and patients about program criteria and status
  • Referring callers to appropriate health care services or resources
  • Verify all patient's eligibility and provide follow-ups by phone, online methods, fax and mail based upon each patient's situation
  • Provides assistance to physician office staff, hospital staff and patients to complete and submit all essential insurance forms and program applications
  • Collects and reviews all patient private or government insurance benefit information, to degree authorized by SOP guidelines of program
  • Process enrollment forms and patient's refills for program within contractual timeline
  • Performed essential duties and responsibilities with minimal supervision
  • Ensuring that information is accurately obtained and documented in detail in program database
  • Schedule 100+ distributions for medication for Specialty drugs such as Diabetes, Oncology, Blood Thinners, and Vaccines to Health Care Providers for patient assistance or Reimbursement
Benefits Investigation Specialist, 11/2011 to 01/2012
AmerisourceBergen – City , STATE
  • Perform insurance benefit verifications on behalf of being 3rd party liaison between Private Payers, OHI, and Physicians staff for patients./Assist in identifying for future review, analysis, or procedure implementation
  • Work directly with multiple insurance websites to obtain benefits and authorization validation by reviewing and verifying appropriate billing and coding for products
  • Complete appropriate electronic forms with detailed benefit and pre-certification/ authorization information to ensure accurate clean claim. Locate, interpret and analyze detailed medical policies, EOBs and claim denials
  • Provide reimbursement for FDA approved products/Assess patient, eligibility for program enrollment ensuring timeliness and accuracy
  • Experience with physicians-administered products/ Effectively work with multiple teams across organization
  • Processed 13+ EOB daily for approval/denial claims
Education
Bachelor of Arts: Psychology, Expected in 12/2020
Southwestern College - City, State
Associates of Science: Criminal Justice, 2019
Ashworth College - City, State
  • Graduated magna cum laude
Associates of Science: Psychology, 06/2018
Ashworth College - City, State
  • Graduated cum laude
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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.

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Resume Overview

School Attended

  • Southwestern College
  • Ashworth College

Job Titles Held:

  • Crisis Counselor (Volunteer)
  • Reimbursement Counselor
  • Patient Case Coordinator
  • Benefits Investigation Specialist

Degrees

  • Bachelor of Arts : Psychology , Expected in 12/2020
    Associates of Science : Criminal Justice , 2019
    Associates of Science : Psychology , 06/2018

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