CUSTOMER SERVICES REPRESENTATIVE FOR MEDICARE & MEDICAID Resume Example
Healthcare professional with 25 years hands-on experience in fast-paced environment into the Medical and Insurance field. Accountable and Responsible with a strong focus on patient wellness and education. Excellent working knowledge of Computers Application including Microsoft Office Windows, Multiple Telephone line, Excel andTyping.
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- CRT usage to retrieve membership and claims information.
- Claims processing and educated member and providers on there explanation of benefits and provider remittance advices.
- Made reasonable procedure exceptions to accommodate unusual customer requests.
- Provided accurate and appropriate information in response to customer inquiries.
- Worked with upper management to ensure appropriate changes were made to improve customer satisfaction.
- Built customer loyalty by placing follow-up calls for customers who reported product issues.
- inform and educated members on there billing/invoicing set up and billing payment procedures.
- Assisted 20 Case Manager and Social worker on a daily basis.
- Daily correspondence with proper placement for several nursing home and community agency for patient safety in a timely manor.
- Coordinated nursing department activities to ensure availability of appropriate clinical and support staff for resident care.
- Established and maintained systems that safely met residents' needs.
- Developed a system of staff communication that ensured proper implementation of treatment plans and comprehensive patient care.
- Transcription and maintained doctors orders.
- Organized and converted hospital lunchroom into a make shift emergency room during the 2003 blackout.
Two years of Radiological Program and Hands on Clinical Training at
- Imperial Point Hospital , Emergency Room and OR.
- Holy Cross Health Plex, Out patient facility
- 7 Avenue Clinic an Affiliate of Broward General Hospital .
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Resume Overview
School Attended
- MEDVANCE INSTITUTE
Job Titles Held:
- CUSTOMER SERVICES REPRESENTATIVE FOR MEDICARE & MEDICAID
- SOCIAL WORKER & CASE MANANGER ASSISTANCE
Degrees
- OCCUPATIONAL ASSOCIATES DEGREE : RADIOLOGY TECHNOLOGY 2009
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