Livecareer-Resume

Customer Service Provider Relations Representative Resume Example

Love this resume?

By clicking Build Your Own Now, you agree to our Terms of Use and Privacy Policy

Jessica
Claire
resumesample@example.com
(555) 432-1000,
Montgomery Street, San Francisco, CA 94105
:
Professional Summary

Enthusiastic Professional eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Clear understanding of Medical Insurance and Billing aspects and analyzation. Motivated to learn, grow and excel in the Medical Billing and Coding industry.

Skills
  • CPT Coding
  • Medical Billing and Coding
  • Medical Terminology
  • EOR/EOB
  • Claims Adjustments
  • Insurance claims analysis
  • Proficiency in MS Office
  • CMS-1500/UB-04 Claim Form
  • Workers Compensation Insurance
  • Medical claims coding
  • Medical Insurance Verification/Precertification
  • Professional Customer Service
  • Provider support
  • Provider relationship management
Education
Ultimate Medical Academy Tampa, FL, Expected in 2017 Associate of Science : Medical Billing and Coding - GPA :
  • Graduated with 4.0 GPA
Work History
Assistrx - CUSTOMER SERVICE/PROVIDER RELATIONS REPRESENTATIVE
Orlando, FL, 04/2020 - Current
  • Assists providers via phone and email with basic to complex bill review questions and requests.
  • Managed over 95 provider calls per day.
  • Understand and be able to properly explain provider contracted rates, carve-outs, and special LOAs applied to medical bills
  • Managed provider relations mailbox by triaging inquiries, facilitating resolution of incoming requests while forwarding requests to appropriate parties.
CorVel Corporation - MEDICAL BILL REVIEW ANALYST
City, STATE, 03/2019 - 04/2020
  • Applying knowledge of medical terminology, medical billing guidelines, and fee schedules, Including CPT/ICD/HCPS coding and Knowledge of UB-O4 and CMS- 1500 form types.
  • Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
  • Performed billing and coding procedures for ambulance, emergency room, impatient and outpatient services.
  • Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
Horizon Eye Care - PATIENT ACCESS SPECIALIST
City, STATE, 02/2013 - 08/2018
  • Obtained patient's insurance information and determine eligibility for benefits for specific services rendered for over 75 patients per day.
  • Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
  • Received patient deductibles, co-pay amounts and discussed options to satisfy remainder of patient financial obligations.
  • Determined patient financial needs and referred eligible patients to proper county, state or federal agencies to obtain financial assistance.
Affiliations

National Honor Society- Alpha Beta Kappa |Ultimate Medical Academy Online-Epsilon Gamma Of Florida- December 2017

By clicking Build Your Own Now, you agree to our Terms of Use and Privacy Policy

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.

How this resume score could be improved?

Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:

98Excellent

Resume Strength

  • Formatting
  • Length
  • Measurable Results
  • Personalization
  • Strong Summary
  • Target Job
  • Typos
  • Word Choice

Resume Overview

School Attended
  • Ultimate Medical Academy
Job Titles Held:
  • CUSTOMER SERVICE/PROVIDER RELATIONS REPRESENTATIVE
  • MEDICAL BILL REVIEW ANALYST
  • PATIENT ACCESS SPECIALIST
Degrees
  • Associate of Science