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Remote Patient Service Representative Resume Example

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REMOTE PATIENT SERVICE REPRESENTATIVE
Summary

I have 30 years experience in insurance health claims with The Epoch Group LC aka LaHood & Assoc LC. 25 years of claims examining, processing & adjusting claims. I was also a Team Lead, Supervisor & Manager for Claims Acquisition ( data entry of claims, provider maintenance, eligibility. Basically preparing claims for processing).

The past 6 years I have been a Patient Service Rep in office as well as remote. I also was a Team Lead & Report Specialist for RCP/Avadyne Health.

Highlights
  • MANAGEMENT:

  • TeamLeader/Supervisor/ Manager for 25+ employees including 4 separate departments. (Ability to resolve issues for disgruntled patients/insureds. Conflict Resolution, Team Building, interviewing for new positions, maintaining personnel files, conducting employee reviews, establishing employee disciplinary action as needed & follow through of such action, payroll, internal as well as external customer service, ability to be confidential, organizing meeting, conducting meetings, ordering supplies for department needs)

  • CUSTOMER SERVICE:
  • INFORMATION TECHNOLOGY:
  • verifying electronic data transfers, loading electronic files, transferring data via ftp & sftp sites, ability to run custom program reports, customer service via phone as well as email for IT operations (daily, weekly & monthly) processes. Also provide customer service as Help Desk Agent for our newly implemented IT Help Desk utilizing the Footprints ticketing system of which I helped implement. Daily support and trouble shooting for various systems (including but not limited to: WindowsXP, Excel, Active Directory,
  • Security Requests, RIMS, Citrix, ECS Claims Exchange) for approximately 150+ users including internal employees, home based employees and external clients.

  • CLAIMS ADMINISTRATION:
  • 10 key, data entry, filing, verifying claims, pricing claims, provider
  • maintenance for claims, claims processing, customer service for claims, strong communication skills,
  • Excel, Word, Outlook.
  • RIMS program experience: CBE, CEA, CA, CIL, Spooler,
  • Custom Program:
  • Reports, PM, HI, Phone, PCR, PFSQ, PNF.
  • Avadyne Health program experience: STAR, CPSI, Meditech, Cerner,
  • FACS, EPIC
Accomplishments
  • I earned awards for top producer & collector numerous months. I also earned perfect attendance awards.
  • I have earned the certification for CRCS I & P (dually certified within 6 months)
Experience
04/2009 - 09/2015
Revenue Cycle Partners － Overland Park, KSRemote Patient Service Representative
  • Taking inbound calls from patients who have a self pay balance with a hospital facility. Also making out bound calls to patients who have a self pay balance with a hospital facility. This requires knowing all possible options & deciding which option(s) best fit the needs of the patients. Handling phone calls from subscribers regarding the processing of medical claims.

  • Avadyne Health program experience: STAR, CPSI, Meditech, Cerner, FACS, EPIC.
10/2007 - 02/2009
The Epoch Group LC － Overland Park, KSIT Help Desk Agent

verifying electronic data transfers, loading electronic files, transferring data via ftp amp; sftp sites, ability to run custom program reports, customer service via phone as well as email for IT operations (daily, weekly & monthly) processes.

Also provide customer service as Help Desk Agent for our newly implemented IT Help Desk utilizing the Footprints ticketing system of which I helped implement.

Daily support and trouble shooting for various systems (including but not limited to: WindowsXP, Excel, Active Directory, Security Requests, RIMS, Citrix, ECS Claims Exchange) for approximately 150+ users including internal employees, home based employees and external clients.

01/1996 - 10/2007
Epoch Group － Overland Park, KSPatient Services Representative Team Lead Claims Examiner

Claims Examiner, Processor, Adjuster, Team Lead

Claims Acquisition Team Lead, Supervisor, Manager


CLAIMS ADMINISTRATION: 10 key, data entry, filing, verifying claims, pricing claims, provider maintenance for claims, claims processing, customer service for claims, strong communication skills, Excel, Word, Outlook.

RIMS program experience: CBE, CEA, CA, CIL, Spooler, Custom Program: Reports, PM, HI, Phone, PCR, PFSQ, PNF.


Education
1984
Paola High School － Paola, KS, USAHigh School Diploma
Skills

10 key, Active Directory, balance, Citrix, strong


communication skills, CA, Conflict Resolution, clients, customer


service, CUSTOMER SERVICE, customer service training, data entry, email, filing, ftp, Help Desk, Team


Building, Team Leader, Teambuilding, Meditech, meetings, Excel, Exchange, Outlook, Windows XP, WindowsXP, Word, organizing, payroll, PCR, personnel, pricing, processes, RIMS, Supervisor, Phone, trouble shooting, Troubleshooting

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Resume Overview

Companies Worked For:

  • Revenue Cycle Partners
  • The Epoch Group LC
  • Epoch Group

School Attended

  • Paola High School

Job Titles Held:

  • Remote Patient Service Representative
  • IT Help Desk Agent
  • Patient Services Representative Team Lead Claims Examiner

Degrees

  • High School Diploma

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