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PHONE NUMBER AVAILABLE EMAIL AVAILABLEPROFESSIONAL PROFILECustomer service oriented and performance driven professional, specializing in claims processing and consumer communication. Pays close attention to detail for accurate and compliant documentation, ability to build trust quickly and navigate challenging conversations successfully. Effective problem solver, able to assess needs and identify solutions. Manages time and prioritizes duties in fast-paced, multi-task environments. Greenway Prime Suite EHR/ Microsoft Word, Excel, and PowerPoint. CORE QUALIFICATIONS 10+ years of Customer Service experience Amazing communications, both verbal and written Specializing in consumer services HIPAA Compliance, Insurance Verification and Claim Processing Co-Payments, deductibles Managed Care (HMO - PPO - POS) Government Payers Third Party Payers - Worker's Compensation Medical Billing - Medical Coding. ICD-9 - ICD-10, HCPCS CPT Medical Terminology - Medicare Medicaid and Tricare - CMS 1500 - CMS 1450(UB-04) Fee Schedules, Medical Office Procedures, Electronic Medical Records (EMR) EDUCATION / CERTIFICATIONUltimate Medical Academy Associate of Science Degree - Medical Billing and Coding, 2019Everest Diploma - Medical Billing and Coding, 2016 American Heart Association CPR & First Aid Certified PROFESSIONAL EXPERIENCEUnited Healthcare - Harvey, IL05/2019 - 09/2023 Customer Service Representative Assisted customers with their health insurance claims Talked with doctors to verify medical services and relayed messages back to customers Ensured customers were satisfied with their services and had proper next steps in placeSykes - Denver, CO08/2018 - 03/2019 Customer Service Representative Took calls from business owners who wanted taxes done. Fielded inbound calls efficiently, assisted with claims, and sent information and links to customers. Provided effective conflict resolution.09/2015 - 08/2018Advantage - Florence, AL Merchandiser Logged into company website and retrieved travel details. Communicated with the Store Manger to make sure necessary supplies were there. Set up merchandise displays for Walmart, Best Buy, and other retail stores. 03/2015 - 06/2015Physicians Corp. - Midlothian, IL Claims Specialist (Paid Externship) Received files and claims; worked claims that needed to be evaluated for denials. Corrected and processed claims. Reached out to the customers and insurance companies about the claim process. Utilized Medisoft and Eclipse EMR and EHR.02/2015 - 03/2015Radius Foundation - Palos Heights, IL Medical Billing (Paid Externship) Contacted insurance companies about outstanding balances. Performed insurance / billing clerical duties. Verified patient account information against insurance program specifications. Used Medisoft and Eclipse EMR and EHR in the completion of duties.