Customer Service Representative Resume Example

Oversaw all operations in the billing office from start to finish under HIPPA. Customer service, appeals, denials, one on one with insurance companies, and handled contracts with insurance companies and the local towns. Scheduled ambulance transports EMD certified to take 911 calls.

• Increased team efficiency by implementing pre-billing process improvements.
• Entered patient insurance, demographic and health information into software and confirmed records.
• Streamlined day-to-day office processes to meet long-term goals.
• Set up patient charts and documented information in various company software.
• Disseminated information to correct department, individual or outside location.
• Provided respectful assistance to all parties, including patients, staff members and insurance company representatives.
• Provided excellent service and attention to customers when face-to-face or through phone conversations.
• Collaborated in development of billi[Type] procedures.

• Filed and submitted insurance claims.
• Managed 8 accounts at once.
• Provided prompt and accurate services through knowledge of government regulations, health benefits and healthcare terminology.
• Completed and submitted appeals.
• Sought clarification from physicians and other hospital personnel for answers to any needed coding interpretations prior to abstracting records.
• Enforced compliance with organizational policies and federal requirements regarding confidentiality.
• Organized information for accounts more than 90 days past due and transferred to collection agency.
• Reconciled codes against services rendered.
• Documented and filed patient data and medical records.
• Reviewed account information to confirm patient and insurance information is accurate and complete.
• Contacted insurance providers to verify correct insurance information and obtain authorization for proper billing codes.
• Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.
• Verified final claim submissions by comparing account charges with documentation.
• Investigated denials and collaborated with internal team members and third-party representatives to identify solutions.
• Utilized electronic charge capture systems to consolidate and streamline billing processes.
• Verified accuracy and integrity of motor vehicle and workers' compensation claims through careful research and analysis.
• Reviewed received payments for accuracy and applied to intended patient accounts.
• Researched and rectified account discrepancies.
• Reviewed all claims for accurateness and appropriateness.
• Reviewed medical records to meet insurance company requirements.
• Effectively coordinated all communications between patients, billing personnel and insurance carriers.
• Added modifiers, coded narrative diagnosis and verified diagnoses.
• Audited medical records and diagnosis codes for accuracy and completion.
• Accurately input procedure codes, diagnosis codes and patient information into billing software to generate up-to-date invoices.
• Answered desk phone and handled phone calls and questions.
• Maintained accurate and timely charge submissions utilizing electronic charge capture practices, including billing and account receivables (BAR) system and medical billing clearinghouse accounts.

• Provided leadership and direction for employees, supervising activities to drive productivity and efficiency.
• Coached and mentored employees by delivering training, guidance and performance monitoring.
• Planned and prepared workflow schedules, delegating tasks for 15-member team.
• Implemented training processes for newly hired employees and supervised department managers, shift leads and production personnel.
• Enforced company policies and procedures to strengthen operational standards across departments.
• Conducted job interviews, led employee performance evaluations with constructive feedback and rewarded top sales performers to attract and retain top-quality personnel.
• Maintained positive work ethic and commitment to providing excellent service to improve operations efficiency and customer satisfaction.