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Title Customer Service Medical Billing
Target Location US-CO-Denver
Email Available with paid plan
Phone Available with paid plan
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Candidate's Name
PHONE NUMBER AVAILABLEEMAIL AVAILABLEMacysFeb Street Address  to currentRetail AssociateCustomer Service: Master store products, services, loyalty programs, and Macys sales systems and use knowledge to help customers find what they need and suggest additional items.Sales Support: Develop customer relationships to grow business and expand our client base. Respond to customer requests for additional merchandise or other assistance.Merchandise Organization: Maintain department recovery standards, including selling floor and fitting rooms.Pricing: Ensure accurate merchandise pricing.June 2022 October 2023Leave of absence of caring for family members medical needs.HCAJune 2005 to June 2022Medical Billing SpecialistDetail-oriented and patient-focused professional with 15+ years of experience in medical billing and customer service environments, specializing in ER account management and charge allocation.Demonstrated success in executing comprehensive billing tasks, navigating complex systems, and facilitating insurance pre-certification/patient verification. Instrumental in anticipating and resolving intricate problems, collaborating seamlessly with team members, and communicating effectively with patients and insurance providers. Known for exceeding defined productivity standards, actively participating in recognition programs, and aligning with stated organizational mission and values. Excel in demanding, fast-paced environments, committed to delivering precise billing processes and exceptional customer service.Areas of ExpertiseMedical Billing & CodingPatient Account ManagementInsurance VerificationAuthorizationCharge Allocation & ReconciliationCustomer CommunicationSupport ResolutionEscalation ManagementTeam CollaborationRegulatory ComplianceCustomer EngagementProfessional ExperienceExecuted comprehensive billing tasks for all ER accounts, meticulously reviewing patient charts for accurate charge allocation. Navigated Meditech to address billing edits through reconciliation reports for precise billing processes. Facilitated insurance pre-certification, patient verification, and surgery interviews for seamless procedural preparations. Identified patient accounts corresponding to PPO, HMO, and other Managed Care Organizations for accurate processing. Managed patient communication module for meticulously updating authorization and benefit information. Resolved billing issues proactively, contributing to effective problem-solving.Anticipated and resolved intricate problems aimed at establishing priorities for efficient solutions.Exceeded primary productivity and performance standards consistently for showcasing exceptional results.Escalated unresolved issues, swiftly recommending effective solutions to minimize future challenges.Verified patient eligibility, authorizations, benefits, and claims with insurance providers and third-party payers.Collaborated seamlessly with team members to optimize workflow efficiency and effectiveness.Communicated with patients to provide timely updates on benefit verification and financial responsibilities.Partnered with ER Department and nursing staff to actively participate in Daisy Award recognition program for evaluating and selecting deserving employees aligning with hospital's mission and values centered around care and quality.Additional experience as Call Center Agent at..Xcel EnergyDenver, COEducationAlfred State CollegeAlfred, NY

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