Intake Specialist Resume Example Company Name

INTAKE SPECIALIST

Professional Summary

Motivated customer service specialist with over 5 of experience in a fast-paced, team-based healthcare environment.

Skills

Customer service skills. Knowledge of HIPPA and OSHA guidelines.

Strong knowledge of Microsoft Office, specifically Excel, Word and Outlook Exchange, proficient in Internet Explorer.

Work History

Company NameIntake Specialist | City, State | July 2015 - Current

Answer incoming calls to the KKI central referral line; reply to written requests for information and /or appointments from patients, families, and external referral sources.
Obtain and document patient clinical, demographic, and insurance information in AS400, intake form and KKI intranet.
Search for and document previous appointments or requests for services by internal/external referral sources.
Communicate with appropriate staff and complete all documentation.
Finalize the intake by communicating disposition to family and/or referral source.
Create appropriate referrals for appointments to be scheduled in IAMS.
Schedule appointments with the Care Center and/or Clinic Coordinators based on Clinic Policy.
Notify Clinical Care Associate of any critical information regarding appointments, insurance, referrals, Letters of Guarantee, etc., as needed.
Check all documentation for grammar, spelling, accuracy, and completeness.
Maintain daily log of intakes done including: number of calls, types of callers, number of referrals created, referral source, etc.

Company NameAccounts Receivable Representative | City, State | March 2015 - July 2015

Access client files if necessary to verify information.
Respond to verbal and written client or responsible party inquiries regarding account status within policy and procedure timeline.
Research accounts and document follow up appropriately.
Resolve account discrepancies and prepare adjustments and refunds for approvals as necessary.
Maintain accurate and complete records concerning billing activity on all accounts.
Document in the system records.
Address problems as they occur.
Keep supervisor advised of area or compliance issues which may lead to untimely or inaccurate completion of invoice or claim submission.
Complete all reports according to schedule.
Prepare, edit and submit account billing in accordance with client contract or payer guidelines.
Ensure all invoices are submitted accurately and timely per policy guidelines.
Utilize several systems to research, document or verify information.
IDX, Emdeon, Availity, Navinet, Passport etc.).

Company NameQuality Assurance Enrollment Auditor | City, State | August 2014 - January 2015

Review processed enrollment for accuracy in accordance with established policies and procedures.
Processes updates directly into systems.
Audit daily work as assigned and communicate quality errors to Enrollment technicians for correction to be completed in a set time frame.
Communicate errors with tact and diplomacy, using positive feedback as a training tool in an effort to improve quality results.
Document all processing errors for feedback to processors and record results in the QA Error Database for matrix reporting.
Perform quality audits with a goal of 99% accuracy based on MTM (Member Touchpoint Measures) quality program administered by Carefirst Blue Cross Blue Shield of Maryland.
Prepare documentation for monthly audits required by carriers, which includes all election forms, supporting documentation or respond to Carrier inquiries.
Adhere to timeframes established by carriers for completion of audits.
Adhere to transmission timeframes to ensure completion of QA review prior to transmission of data to carrier.
Keep abreast of current trends and regulatory issues surrounding carriers plan design and administration.
Additional projects as assigned.

Company NameProvider Services Representative | City, State | July 2012 - June 2014

Answered an average of 60-90 calls per day by addressing customer inquiries, solving problems and providing benefit information.
Developed reputation as an efficient service provider with high levels of accuracy.

Performed investigative tasks to find payment retractions and reviewed processed claims to ensure that they were billed correctly.

Used various claims viewing systems such as QNXT, Emdeon, Claims Vision Suite, MHC, CCMS)

Education

Associate of ScienceNursingCommunity College of Baltimore CountyCity, State | Current

Resume Overview

School Attended

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Degrees