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

Over ten years experience of commended performance in key patient accounts and support roles. Excellent in customer care/communications, problem solving, relationship building and user training and support. Extended Knowledge in Medicare/Medicare and Commercial insurance verification, HMO billing, Knowledge of MS Office with additional proficiencies in assorted databases. HIPPA Compliant, Call Center Operations, Safe guarding of patient information, Complaint Handling Reports & Documentation, Workers Compensation

Skill Highlights
  • Word, Excel, PowerPoint, Access, Outlook, IDX web, EPIC, ePremis, AS400 Mission Statement
  • To strive to meet and surpass customer/ employer expectations by offering exceptional patient service. Maintain customer centricity in all initiatives and interactions, always putting the customer first.
  • Patient Accounts Specialist
  • Offering an award-winning track record of Patient care excellence within high-volume environments that include.
  • Patient Service Desks
  • Patient Access
  • Training and development
  • Key Skills
  • World-Class Customer Service
  • Troubleshooting/ Problem Solving
  • Patient Liaison
  • Insurance and Third Party Payer contact
  • Claims and billing
  • Medicare/Medicare HMO billing
  • Revenue Cycle (Front and Back)
Education and Training
ASHFORD UNIVERSITY ONLINE Clinton, IA Expected in 2017 Bachelors of Arts : Business Management - GPA :
Certifications

Certified Pharmacy Technician- 2015

Accomplishments

Service Excellence Award, 2007,2008, 2009,2010,2011,2012

17 C.A.R.E. Awards, 2006-2012

Obtained Certified Pharmacy Technician license - 2015

Professional Experience
Argo Ai - Insurance Analyst
Detroit, MI, 09/2013 -

Investigate patients insurance benefits and financial assistance opportunities.

Act as a liaison between department personnel, insurance companies and providers to determine the patients overall prescription benefit package.

Provide subject matter expertise on claim billing, insurance verification, prior authorization and appeal filing, along with financial assistance opportunities.

Communicate with insurance payors and providers to investigate pharmacy and medical benefits and determine patients financial responsibilities.

Perform Quality Assurance on benefit verifications and escalate issues and concerns to management.

Assist offices through the entire document process for prior authorizations and or appeals.

Build and maintain positive relationships with insurance companies and key referral sources.

Meet all performance metrics.

Ensure compliance with federal regulations, HIPPA and insurance requirements

Maintain patient records and confidentiality


Common Spirit - Medical Billing Representative/Trainer
Centerville, IA, 01/2012 - 09/2013

Ensures compliance with federal regulations, HIPPA and insurance requirements.

Maintain patient records and confidentiality

Ensures claims are coded correctly and billed within a timely fashion

Effectively train all new staff, as well as over-seas (India Based) staff on Revenue Cycle software, Billing, insurance- verification, follow-up.

Identify development needs through employee evaluation and upper management consultation.

Helping department managers identify and correct training issues through individual or group training.

Act as liaison between upper management and hourly employees

Run reports for late charges and DRG changes.

Knowledge of insurance guidelines, with an emphasis in Medicare/Medicare HMO

NORTHSHORE UNIVERSITY HEALTHCARE - Patient Access Rep
City, STATE, 2006 - 2012

Ensured compliance with federal regulations, HIPPA and insurance requirements

Identified opportunities to increase patient satisfaction through the use of excellent communication skills

Effectively trained new staff on Revenue Cycle software, payment posting, insurance verification and follow-up protocol and practices

Acted as liaison between patient and insurance companies as well as between staff and management

Obtained Medicare/Medicaid Authorizations for Outpatient Procedures

Answered inbound calls

Scheduled and Registered patients for outpatient/inpatient procedures

HENRY FORD MEDICAL SYSTEMS - Commercial Billing Rep
City, STATE, 01/2002 - 01/2006
  • Provided telephone, online and face-to-face customer service/support within high-volume call centers (handling an average of 95 calls/internet inquiries daily) Duties Accretive Health: Ensures compliance with federal regulations, HIPPA and insurance requirements.
  • Maintain patient records and confidentiality Ensures claims are coded correctly and billed within a timely fashion Effectively train all new staff, as well as over-seas (India Based) staff on Revenue Cycle software, Billing, insurance- verification, follow-up.
  • Identify development needs through employee evaluation and upper management consultation.
  • Helping department managers identify and correct training issues through individual or group training.
  • Act as liaison between upper management and hourly employees Run reports for late charges and DRG changes.
  • Knowledge of insurance guidelines, with an emphasis in Medicare/Medicare HMO Northshore University Healthcare Ensured compliance with federal regulations, HIPPA and insurance requirements Identified opportunities to increase patient satisfaction through the use of excellent communication skills Effectively trained new staff on Revenue Cycle software, payment posting, insurance verification and follow-up protocol and practices Acted as liaison between patient and insurance companies as well as between staff and management Obtained Medicare/Medicaid Authorizations for Outpatient Procedures Answered inbound calls Scheduled and Registered patients for outpatient/inpatient procedures HENRY FORD MEDICAL SYSTEMS Provided telephone, online and face-to-face customer service/support within high-volume call center (handling an average of 95 calls/internet inquiries daily) Ensured compliance with federal regulations, HIPPA and insurance requirements Ensured claims were coded correctly and billed within a timely fashion Knowledge of insurance guidelines, especially Medicare/Medicare HMO and Medicaid.
Skills

AS400, EPIC, Medical billing, Excellent communication, Consultation, Customer Service, Medical and Pharmacy Insurance, Microsoft Access, Excel, Outlook, PowerPoint, Word, Patient liaison, Problem Solving, Troubleshooting.

Affiliations

Abbvie Black Business Network

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Resume Overview

School Attended

  • ASHFORD UNIVERSITY ONLINE

Job Titles Held:

  • Insurance Analyst
  • Medical Billing Representative/Trainer
  • Patient Access Rep
  • Commercial Billing Rep

Degrees

  • Bachelors of Arts

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