SEARCH

Customer Service Advocate Resume Example

Resume Score: 90%

Love this resume?Build Your Own Now
CUSTOMER SERVICE ADVOCATE
Summary

Detail-oriented Administrative/ Clerical support with extensive experience performing medical clerical duties and supporting 5 physicians in a busy medical office. Expertise includes with excellent communication skills demonstrated by18 years of experience, verifying insurance coverage, records reviews and schedule maintenance.

Highlights
  • Results-oriented
  • Maintains strict confidentiality
  • Meticulous attention to detail
  • Excellent communication skills
  • Team player with positive attitude
  • Strong work ethics
Experience
Customer Service Advocate
May 2014 to CurrentCompany Name － City, State
  • Provided accurate and appropriate information in response to customer inquiries by Medicare Part B providers
  • Explain Medicare Part B claim denials and how to correct claim for payment.
  • Provide reference and resource material to providers and conduct research into some denials
  • Verify and confirm beneficiary eligibility in Medicare Part A and B.
  • Strictly followed all federal and state guidelines for release of information.
  • Examined diagnosis codes for accuracy, completeness, specificity and appropriateness according to services rendered.
Customer Service Representative
September 2013 to May 2014Company Name － City, State
  • Addressed customer service inquiries in a timely and accurate fashion.
  • Explaining current Medicare D drug plan to members
  • Taking medication refill orders
  • Researching plan design copay structures and formulary change
  • Providing pleasant, accurate customer service
  • Providing information regarding changes to Medicare Part D drug plan structures Providing Medicare mandates procedures and updates.
Surgery Scheduler
March 1999 to June 2013Company Name － City, State
  • Efficiently performed insurance verification and pre-certification and pre-authorization functions.
  • Sending redetermination to insurance both private and government for surgical procedures
  • Coordinate surgery schedule with patient, physician and operating room and provide patients with detailed information regarding dates, time scheduled and necessary
  • Arrange and schedule pre-operative test for patient and maintains operating room schedule instructions, as directed by physicians.
  • Contact patient to remind of post-operative instructions, as directed by physicians.
  • Working knowing in Star Panel, Epic Hyperspace, and other systems
  • Verify patient eligibility, coverage for procedure,obtain pre-certifications, authorizations for procedures and tests ordered by physician.
  • Notify and forward paperwork for insurance certification to Billing Office and obtain additional paperwork if needed for compliance.
  • Responds to written and telephone inquiries from carriers regarding surgeries
  • Perform clerical duties to support physicians and the surgery scheduling function regarding patient and surgery information
Office Assistant III
February 1996 to March 1999Company Name － City, State
  • Responsible for printing daily schedules to pull medical records for clinic appointments and surgeries.
  • Recorded and filed patient data and medical records
  • Scanned and indexed clinic notes, pathology reports, lab tests, financial information in Electronic health record system
  • Performed various administrative duties, including data entry and document preparation.
  • Eliminated outdated records on annual basis by sending the records to be scanned
  • Assisting medical students, doctors, nurses and secretaries archival retrieval
  • Pick up, sort and distribute mail for clinic.
Clerk III
January 1995 to February 1996Company Name － City, State
  • Developed and created a more effective filing system to accelerate paperwork processing.
  • Printing daily schedules, pull medical records for clinic.
  • Verified that information in the computer system was up-to-date and accurate for appointments and surgery.
  • Dispersed incoming mail to correct recipients throughout the office.
Education
Bachelor of Science : Health Care Administration with Concentration in Management, 1991University of Phoenix － City, State

Health Care Administration ,still in progress will graduate June 2016

High School Diploma : Psychology , 1990Belmont University － City, State

Studies included Statistical Mathematics, Western Civilizations , Majoring in Psychology Minor in Sociology

Algebra I & IIStratford High School － City, State

Studies included Algebra I &II and Trigonometry, Geometry and French I &II H

Accomplishments
  • Healthcare Administration- still in progress Accomplishments Certificate thru Vanderbilt Training and Development Organizational Skills Certificate received on June 22, 2000.
  • Attendance in Tenn-care in-service May 2003, January 2004, March 2004, July 2005, August 2005 for BCBS pre-certs.
  • Working knowledge in Excel and with CPT coding, Completion of Administrative Assistants Conference September 2008.
Skills

Scheduling, Strong verbal skills, Excellent written skills, ICD-9 and CPT coding

Build Your Own Now

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.

Resume Overview

School Attended

  • University of Phoenix
  • Belmont University
  • Stratford High School

Job Titles Held:

  • Customer Service Advocate
  • Customer Service Representative
  • Surgery Scheduler
  • Office Assistant III
  • Clerk III

Degrees

  • Bachelor of Science : Health Care Administration with Concentration in Management , 1991
    High School Diploma : Psychology , 1990
    Algebra I & II

Similar Resumes

View All
Customer-Service-Advocate-resume-sample

Customer Service Advocate

Harrisburg, Pennsylvania