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Customer Service Sales Representative

Location:
United States
Posted:
January 24, 2015

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Resume:

MARCIA BOYD

Atlanta abl1ze@r.postjobfree.com 404-***-****

Georgia www.linkedin.com/in/boydmarcia

SUMMARY OF QUALIFICATIONS

Extensive experience in customer service, billing, collection, and support. Recognized

strengths in account maintenance, detail oriented, analytical, and trouble-shooting. Adept in

planning/implementing proactive procedures and systems to avoid initial problems.

SOFTWARE APPLICATIONS AND BUSINESS PRACTICES

• Medicaid Management Information CPT Coding

system - MMIS ICD 9

HEREA Billing Application Microsoft Office Suite

• •

EPIC Billing Application Microsoft Excel

• •

PCS Billing Application Microsoft Access

• •

HDX Billing Application Internet Explorer

• •

FACETS & NASCO claims Microsoft Outlook

• •

Applications

PROFESSIONAL EXPERIENCE

HP Enterprise Services (GA Medicaid), Tucker, GA 2012 – 2014

Insurance/Healthcare Representative III

• Verified the receipt and payment or denial of claims

• Respond to 120 calls per day regarding member and provider eligibility, claim submission

procedures, and claims processing

• Consistently received compliments on being helpful and friendly by members and

providers

• Help train thirty new employees with the claims process and taking calls

Healthscope Benefits Columbus, Ohio 2010- 2011

Customer Service Representative

• Reviewed 300 claims a week checking for errors and correcting the claims with the errors

• Made up to 50 outbound calls per day to providers for additional medical information

• Took 75 inbound calls from employees concerning medical benefit questions

OSU Internal Medicine, Columbus, Ohio 2006- 2010

Patient Account Representative

• Was recognized as one of the go to individuals with Strong third party payer knowledge of

claims which include but not limited to Medicare, Medicaid, Blue Cross, Worker's

Compensation, and Managed Care

• Assisted other employees in the Revenue Cycle with insurance follow-up, insurance

verification, charge entry, credit balance.

• Ensure compliance on all fronts including billing is in accordance with governmental and

insurance contract terms daily

2

• Reviewed all billing for accuracy and coordinated up to 50 correspondence between

provider and patient payments per day.

Bioscrip, Columbus, Ohio 2005- 2006

Customer Service Insurance Representative

• Supported three sales representative in opening new accounts and upgrading existing

services which included follow up with potential clients, set new clients up in the system,

and update any changes in the system.

• Successfully resolved customer challenges with a lean and agile approach

• Created, Analyzed, synthesized, and aggregated financial reports quarterly for upper

management.

• Researched 50 rejected claims filed by insurance agencies per day

• Maintained 50 accounts for quality control and satisfaction

Cigna Healthcare, Atlanta, Georgia 1999- 2005

Benefit Analyst

• Reviewed and process 125 medical claims for physicians to determine accuracy per day

• Effectively communicated with 50 employees and benefit vendors on pertinent benefit

matters per day

• Successfully reviewed and prepared approximately 20 claim summary reports each

quarter for various insured and self-insured plans

• Assisted in the design and delivery of benefit-related programs at the end of the year that

was cost-effective, affordable and met the needs of the business and team members.

Received kudos on a job well done by upper management

EDUCATION

Advanced Career Training (ACT), Certificate of Network Technology

Atlanta, Georgia

Whitney Vocational Tech, Diploma

Toledo, Ohio



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