A position in an Organization where my strength in communication, leadership, information management, problem analysis, problem solving skills will contribute to achieving the Organization's goals and objectives.
Customer Account RepresentativeMay 2015 to Current City of Tulsa － Tulsa, OK
Responsible for assisting City of Tulsa citizens in responding to customer complaints and inquiries regarding policy and procedures, high accounts and credit arrangements, Process citizen's requests and inquiries as it pertains to water, sewage, refuse and storm water services, Submit service orders for field inspectors on water, refuse, sewage complaints.
Accounts Receivable/Admission RepresentativeMay 2014 to Feb 2015 Parkside Hospital Inc － Tulsa, OK
Responsible for generating inpatient and outpatient Medicaid and Medicare and Medicare Replacement claims, Mail out claims, Follow up and collect payments, Monitor customer account details for non-payments and delayed payments, Carry out billing, collection and reporting activities according to specific deadlines.
Maintain patient files and accounts, process adjustments, process credit card payments.
incoming patients or representatives and enters information required for
admission into computer database.
verifying all patient insurance coverage and benefits for services,.
of payment responsibilities, Distributes appropriate information to
Customer AdvocateOct 2011 to Apr 2014 HCSC/Blue Cross Blue Shield of Oklahoma － Tulsa , OK
Responsible for working on the phones with providers to assist members and physicians by responding to telephone and written inquiries regarding authorizing upcoming medical procedures in a prompt, accurate and objective manner.
Customer Service RepresentativeNov 2010 to Sep 2011 Metropolitan Life － Tulsa, OK
Under supervision, answer incoming telephone calls from dental group coverage participants in a call center environment.
Interpret complex benefits and claims issues.
Cross Selling Life Insurance products to potential customers.
Office AdministratorAug 2005 to Aug 2008 Rock Roofing Company － Lancaster, CA
Answered telephone calls from prospective clients, Adhere to federal/state/local guidelines, Identified and diagnosed potential problems, Interviewed/hired potential employees, Maintained installation and service records, Maintained vendor relations, typed invoices and proposal bids for prospective clients, ordered equipment and supplies, Maintained employee files and processed payroll.
Act as a barometer, having a sense for the issues taking place in the environment and keeping leadership team updated.
Maintained office supplies inventory by checking stock to determine inventory level.
Customer Service LeadNov 2001 to Jan 2002 Medical Pathway － Arcadia, California
Answered telephone call and correspondence from providers and/or subscribers regarding claim payment issues for closed medical groups, Responsible for helping implement department policy and procedure , Researched and responded to provider inquiries regarding past payment and eligibility issues.
Appeals and Grievance Administrative AssistantMay 1999 to Jul 2001 •Kelly Temp Services at Anthem /Blue Cross of California － Woodland Hills , CA
Under minimal supervision, received and review and prepared health cases from members and providers appealing denied services both prospectively and retrospectively for the RN to review.
Prepared correspondence to members, physicians and other providers within predetermined time frames, Contacted providers by telephone and letter to request additional clinical information.
Prepared files by arranging medical records in a logical and consistent sequence for the RN to review.
Responded to incoming calls from members and providers requesting status of appeals, Corresponded through letters to providers and members upon resolution of appeal.
Quality Assurance CoordinatorFeb 1995 to Mar 1999 Health Net － Woodland Hills, CA
Monitored Health Net's PPG compliance with submitting the NCQA, Department of Health Services.
Prepared weekly and monthly reports to Medical Program Managers, Delegation Sub-Committees and Health Net management with the status of compliance.
Maintained contracts of each of the Health Net providers.
Responsible for sending correspondence to Medical Group Directors and President of Boards of Directors for documents that have not been submitted in a timely fashion.
Served as a resource for several departments within Health Net at time of corporate survey.
Bachelor of Science Degree, PsychologyMay 2015University of Phoenix at Tulsa － OklahomaPsychology