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Rep 1 Customer Care Resume Example

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REP 1 CUSTOMER CARE
Summary

Dedicated and empathetic healthcare professional with 10 years' experience of providing organization and structure to a medical office environment. Forward-thinking and resourceful with strong attention to detail and a positive and upbeat mentality. Highly skilled in working within collaborative environments and utilizing effective problem-solving techniques. Excellent communication and interpersonal skills with patients, families and other healthcare professionals.

Skills
  • Computer and technology savvy
  • Professional telephone voice
  • Adept knowledge of Epic and Centricity EMR
  • Strong understanding of HIPPA and privacy laws
  • Exemplary call documentation
  • Excellent written and oral communication
  • Creative problem solving
  • Quick learner
  • Critical thinker
  • Conflict resolution
  • Technologically savvy
  • Adaptive team player
  • Organizational strengths
  • CPC-A Certified ICD-10-CM, CPT and HCPCS
Experience
Rep 1 Customer Care11/2019 to CurrentCVScaremarkPhoenix, AZ
  • Educate participants in need of assistance with their prescription benefits.
  • Evaluate participant account information to assess current issues and determine potential solutions.
  • Uphold a high degree of discretion regarding sensitive and confidential matters.
  • Comply with privacy and security requirements established by HIPAA.
  • Effectively utilized resource solutions using company databases and references.
  • Maintained calm, professional, friendly demeanor to de-escalate upset participants, and resolve issues with prescription benefits.
  • Cultivate professional member relationships by asking appropriate questions, identifying needs and providing insightful information regarding client's products
  • Informed members about billing procedures, and processed payments.
Medical Coder01/2016 to 07/2018Providence Health Systems, Finance DepartmentPortland, Oregon
  • Communicated with healthcare personnel and providers to optimize documentation and ensure accuracy.
  • Interpreted medical reports to apply appropriate ICD-10, CPT and HCPCS codes.
  • On-site support for Infectious Disease, Travel Clinic, Dermatology, Urgent Care, with remote support for Hospitalists, Psychiatry, Pediatrics, Family medicine and Internal medicine.
  • Applied coding rules established by the American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
  • Observed confidentiality and safeguarded all patient-related information per HIPPA and privacy laws.
Lead, Patient Relations Representative10/2008 to 12/2015Providence Medical Group, Scholls ClinicTigard, Oregon
  • Provided administrative support to Internal Medicine, Family Medicine and Immediate Care providers, leadership, and clinical staff.
  • Performed as Interim Clinic Supervisor.
  • Actively worked with leadership to attain a level 3 PCMH.
  • Initiated and performed as In-clinic Referral coordinator.
  • Liaised between employees and senior leadership to address concerns and foster problem resolution.
  • Quality control work queues for registration, insurance entry, charge review, and claim edits.
  • Generated West Side On-Call schedule for 11 primary care providers.
  • Answered back to back inbound calls and directed to designated individuals or departments.
  • Monitored daily phone statistics and delegate coverage in real-time.
  • Provide weekly and monthly reports to leadership.
  • Trained clinic staff on new workflows, policies and provided support to navigate new information.
  • Prepare daily deposits and process incoming invoices.
  • Process Physicians Continued Medical Education paperwork.
  • Delegate daily tasks to clinic patient relations representatives.
Patient Relations Representative05/2008 to 11/2008Providence Medical Group, Staffing DepartmentPortland, Oregon
  • Met or exceeded call speed, accuracy and volume benchmarks on a consistent basis.
  • Answered constant flow of patient, pharmacy, home health and provider calls in a call center setting; answering 80-100 calls per day.
  • Maintained patient happiness with forward-thinking strategies focused on addressing patient needs and resolving concerns.
  • Compiled patient information and input into Centricity EMR database.
  • Efficiently scheduled appointments for 12 providers based on optimal patient loads and clinician availability.
  • Adhered to strict HIPAA guidelines at all times to protect patient privacy.
  • Carefully transcribed phone messages and relayed to appropriate personnel.
Education and Training
High School DiplomaGresham High SchoolGresham, OR
Accomplishments
  • 2015 - 2016 Patient and Family Advisory Council, Clinic Coordinator
  • 2012 - 2015 Epic EMR Optimization and Super User Team
  • 2014 - 2015 Providence Medical Group, Scholls Clinic Dream Team
  • 2009 - 2015 Preceptor, Patient Relations Representatives
Certifications

AAPC Certified Professional Coder Certificate ICD-10-CM, CPT, HCPCS level II Coding Proficiency

Websites, Portfolios, Profiles
  • www.linkedin.com/in/michelle-petersen-CS2019
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Resume Overview

Companies Worked For:

  • CVScaremark
  • Providence Health Systems, Finance Department
  • Providence Medical Group, Scholls Clinic
  • Providence Medical Group, Staffing Department

School Attended

  • Gresham High School

Job Titles Held:

  • Rep 1 Customer Care
  • Medical Coder
  • Lead, Patient Relations Representative
  • Patient Relations Representative

Degrees

  • High School Diploma

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