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Click here or scroll down to respond to this candidateCandidate's Name
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PHONE NUMBER AVAILABLEEMAIL AVAILABLEPROFESSIONAL SUMMARYWell-rounded professional able to serve as initial and ongoing point of contact to deliver high quality customer service. Able to prioritize workload and perform in fast-paced, high demand environments. Communicate effectively to build and maintain positive relationships. Act in a highly professional manner and demonstrate commitment to the mission and values of the company.Academic Honors Recognition / Dean's List / Honor Roll.Communication Platforms Zoom and Google Meet.Microsoft Office Applications Word, Excel, and PowerPoint Type 40 WPM. CORE QUALIFICATIONSMedical Billing Accounts Receivable Collections Co-Pay Deductibles Co-Insurance EOBs Revenue Cycle Management Posting Payments Government (Medicare & Medicaid) Third Party Payers Electronic Health Records (EHR) Electronic Medical Records (EMR) Managed Care (HMO, PPO, and POS) Workers Compensation Insurance Verification Insurance Claim Processing CMS 1500 CMS 1450 (UB-04) Front Office Operations Medical Office Procedures Scheduling Medical Terminology Anatomy & Physiology HIPAA Compliance Medical Coding (ICD-10, HCPCS, CPT) EDUCATIONUltimate Medical Academy Diploma Medical Billing and Coding, 2023 Ultimate Medical Academy HIPAA Essentials for Healthcare Professionals Certificate WORK EXPERIENCEContinuum/Aetna, BlueCross/BlueShield & Cigna Wadesboro, NC 09/2023 01/2024 Benefits Verification Specialist WFH Agent Contracted (Remote)Handle inbound and outbound telephone calls.Followed HIPAA regulations and Aetna, BlueCross/BlueShield and Cigna procedures and policies.Accepted a 6090-day contract to assist members concerning their healthcare plans.SPRX Medical Management Software: verify the members demographics, and healthcare plan.Microsoft office: Word, and Excel; review/draft letters, and update reports/spreadsheets.Insurance verification: confirmed coverage and eligibility.Processed prior authorizations, referrals, and prescription claims.Outreaches to members regarding missing information or outstanding balances regarding the prescription claim.Update members account information to ensure receipt and proper processing of the payments. Roses Discount Store Wadesboro, NC 05/2023 09/2023 Retail Cashier / Customer ServiceServe as direct point of contact and deliver excellent customer service with a positive attitude.Managed the telephone and provided excellent service to all consumers and regular patrons.Operate cash register, scan merchandise, accept payments, ensure accuracy of cash drawer, stock shelves, and keep work area clean and organized.Work as part of a team and interact with diverse customers and staff members. Stay-at-Home Parent Wadesboro, NC 10/2022 04/2023 HomemakerShowed strong leadership skills and managed household budget.Remained deadline-oriented and reliable while adjusting priorities and managing time wisely.Made quick decisions, and maintained a fair, consistent set of standards. Purdue Wadesboro, NC 02/2022 09/2022Package HandlerLoaded materials and products onto package processing equipment.Paid close attention to detail to ensure compliance to standards of packaged products.Worked cooperatively in a fast-paced environment to meet established timelines. ADDITIONAL EXPERIENCECarolina Apparel Group Inc. Wadesboro, NC Seamstress 01/2021 12/2021 Pizza Hut Wadesboro, NC Server / Customer Service 06/2020 10/2020 |
