| Candidate Information | | Title | Customer Service Medical Assistant | | Target Location | US-FL-Winter Park |
| | 20,000+ Fresh Resumes Monthly | |
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Click here or scroll down to respond to this candidateEducationLake Sumter Community College January Street Address - 2022Medical techFTC College Orlando~ UCF FL July Street Address
Bachelor of Science/ Allied Health ManagementMaven Institute June Street Address
Certificate: Medical Administration, Billing and CodingProfessional SummaryMedical professional with over Eighteen years of medical business office experience.Healthcare insurance processing experience including claims entry, validation and resolution.Analytical and self-motivated with ambition to succeed.Excellent communication and interpersonal skills.Work well with little supervision and part of a team.Languages: English, French, and Haitian CreoleHealth Information Technology and Administrative SkillsProfessional ExperienceAetna Managed care / Health care insurance Orlando, FL October 2016 June17/2021Health Information Coordinator Clinical RepresentativeAbility to be empathetic and compassionate handled field inbound callsMust assist in accordance within highest principles of fairness ethical guidelinesProvided comprehensives support for all benefits accounts types in a single platform including FSA-HSA-HRA-dependent care, commuter, wellness incentive accounts and more. Initiate process orders per clinical/ confirmed assessment- worked adjudication rejections &quick based drugs review approved accordingly. Skilled in providing excellent customer careFunctional Communications/ among Members inquiries Providers Vendors based upon requestmay be made verbally as in writing / Transferred set up delivery for new and returning ASRx per clinicians internal and external in related to pharmacy benefits. Precert Authorization & correspondence letters and documented issues and resolutions in a common databasePotential TAT Timeliness of Pre-service/ Concurrent review & Post-service review decision committed to addressing customer concerns with speed, accuracy and professionalismHandling conflict / Evaluates decision notifications to Practitioners & Members whetherdenial notification includes specific reason for the denial or used to informed an appeal rightect..Florida Hospital Medical Group/ Health Information Receptionist March 2015 - April 2016An experienced Customer Service Rep/ Claims Processor with excellent in processing orders, assisting with copay, referrals, and submit payment for billing. Verified registration demo and insurance, patient check in/outProcessed charges coded ICD-9/ ICD-10 Verified CPT-HCPCS CodingScheduled appointment and diagnostic testing, Filling electronic chart trackingPrepping, Scanning paper records into imaging system to create permanent onlineInterpreter Services in French and Haitian CreoleConnextions /AARP United Health Care Orlando, FL June 2011- August 2014Customer Service Inbound Outbound/ OutboundResolve customers inquiries.Assist customers with billing, health and grievance and website support.Notate daily customer inquiries and or assistance on electronic files.Perioperative Service Logger Biller & Coder/Certified Medical AssistantExhibited proficiency with med soft coding and billing, including EOB formsDemonstrated familiarity with medical terminology, ICD-9 codes and CPT-9 codesProvided general medical billing office servicesDemonstrated proficiency as a medical assistantTook vital signs using a tactful, direct and sensitive mannerHome Manager / Family Services of Metro Orlando (Assessment unit)Coordinated services/monthly staff schedules, duty assignments, and care plansMonitored staff attendanceScheduled clients quarterly review meetings and discuss clients progressProvided special instructions referralsMonitored home visit statuses, and assure all resident had a written support service planMonitored risks to minorsConducted client assessment and ISPDeveloped ESS case plan goalsInitiated and coordinated inventory cost controlsMed Tech Support/ Registration clerkConducted laboratory test routines in accordance with MYSISHandled accounts receivable and petty cashMerged Multi-Medical Systems records.Verified insurance referrals/authorizations lab work requisitionsHandled co-payments, and other inquiries, answers screensObtained health insurance pre-approvalsBrockton, Health Center / MBC Hospital Boston, MA August 2003- August 2006Registration Clerk, Lab Assistant, PhlebotomistProvided primary administrative assistanceProcessed lab billing codes and maintained filesScheduled appointments for doctors abroadPrepared and assembled new patient chartsHandled initial certification, recertification of WIC vouchersAccount Specialist IICompiled data for reports in the TIAA CREF Fund GroupRecorded financial transactionsReviewed accountability reports to keep records up-to dateBatch processed new accountsProcessed and verified ACH minimum Investment requirements for subsequent purchases |
