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Click here or scroll down to respond to this candidateCandidate's Name
Street Address PHONE NUMBER AVAILABLE EMAIL AVAILABLEPROFESSIONAL PROFILEWell-rounded professional with insurance claims, retail, management, call center, and customer service experience. Collect and process accurate data in a timely manner to ensure reimbursement for patient services. Follow policies, procedures, and guidelines to ensure consistent quality. Accustomed to handling sensitive and private information.Manage time and priorities in multi-task environments.Effective problem solver, able to assess situation and identify solutions.Work as part of a team and maintain a professional and positive environment.Healthcare Industry Software: Omni Portico Envolve Dental CVS.Microsoft Office Applications: MS Word MS PowerPoint Typing Speed: 25 WPM.Communication Platforms: Google Meet Zoom.KEY QUALIFICATIONSMedical Billing Accounts Receivable Collections Co-Pay Deductibles Co-Insurance EOBsRevenue Cycle Management Posting Payments Government (Medicare & Medicaid) Third Party PayersElectronic Health Records (EHR) Electronic Medical Records (EMR)Managed Care (HMO, PPO, and POS) Workers CompensationInsurance Verification Insurance Claim Processing CMS 1500 CMS 1450 (UB-04)Front Office Operations Medical Office Procedures SchedulingMedical Terminology Anatomy & Physiology HIPAA Compliance Medical Coding (ICD-10-CM, HCPCS, CPT)EDUCATION & PROFESSIONAL DEVELOPMENTUltimate Medical Academy Associate of Science Degree Medical Billing and Coding, 2023Ultimate Medical Academy HIPAA Essentials for Healthcare Professionals CertificateDepartment of Motor Vehicles Commercial Driving License Class B License #801288961WORK EXPERIENCETeleperformance / Centene Columbus, MS 02/2023 06/2023Member Services Advocate / Customer Service Representative Call CenterInteract with customers via inbound calls to aid with account questions and respond to inquiries.Check status of unpaid and denied claims and process requests for appeals and prior authorizations.Help locate in-network Primary Care Physicians and update demographic and insurance information.Document call activities, pay close attention to detail, and uphold HIPAA guidelines to assure privacy of sensitive and confidential information.Use Omni, Portico, Envolve Dental, and CVS software.Self-Employed Columbus, MS 05/2018 01/2023HousekeeperResponsible for the general cleaning and upkeep of client residences.Team-oriented and dedicated to ensuring highest standards are met.Prioritize and organize work and follow through to ensure duties are accomplished.Maintain confidentiality of client information.Full Time Homemaker Columbus, MS 12/2017 05/2018HomemakerShowed strong leadership skills and managed household budget.Required to make quick, crucial, and often unprecedented decisions.Able to maintain a fair, consistent set of standards.PediaTrust Medical Center Columbus, MS 05/2017 12/2017Driver / AttendantDrove medically impaired children to and from the center.Assisted in loading and unloading all children and stayed updated with the center child safety rules and laws as needed.Documented the time of pickup and drop off and handled light cleaning duties.Ecco Ride Columbus, MS 02/2016 02/2017School Bus DriverTransported students to and from school and related events.Remained alert in heavy traffic or bad weather and followed safety rules and regulations.Prepared and submitted reports and maintained order on the bus.Full Time Homemaker Columbus, MS 05/2015 02/2016HomemakerEnsured household duties were completed and managed household budget.Coordinated medical care, meals, and social activities.Remained deadline-oriented and reliable while adjusting priorities and managing time wisely.Dollar General Columbus, MS 03/2014 05/2015Retail Sales Manager / Customer ServicePromoted from Stocker / Cashier / Shift Leader.Supervised employees, prepared deposits, took inventory, and delegated tasks.Checked in vendors, handled invoices, performed opening and closing duties, and created employee schedules.Trained new hires, completed paperwork, and upsold promotional items. |
