Ambitious Receptionist equipped to handle front desk operations greeting guests, routing correspondence and solving immediate issues. Goal-oriented and meticulous professional with outstanding computer skills and telephone etiquette. Committed to contributing to company growth. Communicative Receptionist recognized for providing first-rate support for corporate decision-makers. Meticulous individual with demonstrated success in administrative process improvements to better serve business and customer needs. Equipped with in-depth software knowledge and skill to quickly pick up tools and tricks. Brings polished speaking voice and professional demeanor. Seasoned Claims Processor evaluating online entry, error correction and quality control review for final adjudication of claims. Strong business and financial acumen with proven success to maintain efficient operations. Extensive knowledge of billing, collections and fiduciary management. Communicative customer service professional motivated to maintain customer satisfaction and contribute to company success. History managing large amounts of inbound calls and sustaining satisfactory relationships with customers. Offers skill with CRM systems paired with outstanding active listening and multitasking abilities.
Skills
Office equipment operations
Organization and efficiency
Recordkeeping and bookkeeping
Meticulous and organized
HIPAA guidelines
Referral verification
Front desk operations
Patient callbacks
Technologically savvy
Telephone etiquette
Records management
Records maintenance
Organization
PPE use
Flexible schedule
Supervision & leadership
Maintenance & repair
Account management
Call center operations
Membership renewals
Training and development
Customer support
Payment processing
Data entry
Database maintenance
Promotional support
Microsoft Office expertise
Product organization
Direct sales
Stockroom procedures
Conflict mediation
Customer relations
High-energy attitude
Schedule mastery
Employee coaching
Quality control
Materials transport
Insurance plan verification
Patient rapport
Medical terminology
Database management
Electronic authorization processing
Medicaid knowledge
Insurance terminology
Credit card payment processing
Report creation
Inbound and Outbound Calling
Payments posting
Transactions reconciliation
Claims review
Regulatory compliance
Reporting abilities
Documentation skills
Regulatory compliance understanding
Experience
08/2016 to Current
Insurance Verification SpecialistBaylor Scott & White Health – Greenville, TX,
Pulled and organized requested documentation.
Worked with office manager to attain operational goals.
Scheduled and confirmed appointments.
Answered and directed incoming calls using multi-line telephone system.
Delivered administrative support to team members by making copies, sending faxes, organizing documents and rearranging schedules.
Maintained daily calendars, set appointments with clients and planned daily office events.
Processed payments and updated accounts to reflect balance changes.
Sorted incoming mail and directed to correct personnel each day.
Oversaw office inventory by restocking supplies and submitting purchase orders.
Entered insurance, demographics and health history into patient database.
Called patients to confirm scheduled appointments and obtain additional details.
Checked patients in and out for appointments and collected co-payments.
Scheduled and followed up on patient appointments, collected and processed patient payments and maintained patient files.
Processed patient payments and scanned identification and insurance cards.
Protected patients by observing strict HIPAA guidelines.
Photocopied insurance cards, documented details and verified patient coverage for upcoming procedures or appointments.
Took messages from patients and promptly relayed to appropriate staff.
Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
Verified that patients had proper insurance coverage prior to procedures or appointment scheduling.
Updated patient and insurance data and input changes into company computer system.
Checked documentation for appropriate coding, catching errors and making revisions.
Instructed clients on amounts covered under benefits plans in easy-to-understand terminology.
Liaised between physician, site of service and billing department to obtain appropriate documentation.
Created and sent time of service letter to inform patient of estimated self-pay balance.
Contacted patients to confirm demographic information and communicate financial responsibilities.
Accessed third-party insurance databases to identify coverage of benefits.
Communicated with cross-functional teams to report insurance company trends.
Determined estimated self-pay portion by calculating charges, co-insurance and deductibles.
Navigated through multiple online systems to obtain documentation.
07/2020 to 06/2022
Call Center Customer Service RepresentativeRocky Mountain Atv, Inc. – Bel Air, KY,
Delivered fast, friendly and knowledgeable service for routine questions and service complaints.
Managed customer expectations by clarifying needs, identifying options and recommending products and services.
Met or exceeded call speed, accuracy and volume benchmarks on consistent basis.
Documented customer correspondence in CRM to track requests, problems and solutions.
Maintained strong call control and quickly worked through scripts to address problems.
Audited customer account information to identify issues and develop solutions.
Pursued networking opportunities to advance client relations skills and enhance customer satisfaction.
Asked probing questions to determine service needs and accurately input information into electronic systems.
Strengthened team performance and productivity by training and inspiring team members.
Resolved customer inquiries, questions and concerns to consistently offer quality service and meet performance benchmarks.
Trained and supervised new employees to promote overall team productivity and consistent service.
Answered incoming calls and provided highest level of professionalism and knowledgeable service to every customer.
05/2007 to 03/2010
Senior Claim Processing SpecialistOU Medical Center Edmond – City, STATE,
Verified claim data correctness in preparation for processing.
Reviewed history records to determine benefit eligibility for services.
Researched medical claims for validity to resolve discrepancies.
Maintained comprehensive database for enrollment data, claim submission and payment information.
Analyzed contracts and claim systems to apply appropriate benefit amounts.
Processed claims according to established quality and production standards and made corrections and adjustments to solve problems.
Addressed customer inquiries to provide information and explanations on coverage and terms, expediting claims.
Coordinated benefits with medical insurance plans and Medicare providers.
Identified client service improvement opportunities in collaboration with team leads and managers to resolve problems.
Built rapport and trust with injured insureds through effective customer service techniques which involved fair and prompt processing of claims.
Education and Training
Expected in 01/2018 to to
Associate of Arts: Secretarial Studies And Office Administration Durham Technical Community College - Durham, NC GPA:
Expected in 06/1994 to to
High School Diploma: South Granville High - Creedmoor, NC, GPA:
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