Customer Service Data Entry

Lonzetta Smith

**** ** **** **., ***’s Summit, MO 64064 816-***-**** ad5mnx@r.postjobfree.com

OBJECTIVE

Professional, driven, and experienced accounts resolution expert with 10 + years in Healthcare and Insurance industries, and a commitment to high standards of service, performance, and integrity. Experience in leading accounting processes to collect client payments, document funds accrual, and resolve discrepancies utilizing enterprise accounting software programs. Highly detailed-oriented and an accurate professional, who is recognized for meeting deadlines and desired results.

AREAS OF IMPACT

§Medical Billing and Coding

§Collections and Claims Customer Service

§Business Operations

§Account Management and Administration

§ICD-9

§CPT Code

§Data Entry and Maintenance

§Accounts Receivable / Payable Database Administration

§Electronic Medical Records

§Insurance Verification

§Provider Contact

§Patient Scheduling

PROFESSIONAL CAREER HISTORY

Account Resolution Specialist - Ascentist Healthcare (September 2021 - Present)

§Resolve medical claims by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter.

§Contact and notify patients of requirements and discrepancies by telephone and approved written correspondence in an attempt to bring resolution to unpaid accounts.

§Assist patients in resolving their accounts by receiving and accepting payments, provide insurance information, and negotiating payment arrangements.

§Document medical claims actions by completing forms, reports, logs, and records.

§ Ensure legal compliance by following company policies, procedures, guidelines, as well as state and federal insurance regulations.

§Ensure superior customer experience by addressing customer concerns, demonstrating empathy and resolving problems.

Account Resolution Specialist - St. Joseph Medical Center (May 2018 – August 2021)

§Receive and resolve patient billing questions and complaints in a compassionate, courteous, professional and timely manner.

§Take appropriate actions such as changing insurance, re-filing claims, calling insurance companies or answering questions to resolve issues as appropriate.

§Review and analyze monthly reports, data and trends to identify opportunities for growth, improve revenue cycle functions and increase productivity.

§Assist patients in understanding financial obligations.

§Responsible for collecting co-payments, self-pay deposits and update patients’ balances as needed.

Supervisor Upfront Review Clerk – Lincare (December 2016 – April 2018)

§Supervise and train 25 Review Clerks regarding the quality review of all pertinent customer information for accuracy and completeness.

§Setting performance goals and deadlines in order to meet payer requirements for timely and maximum reimbursement.

§Delegate work as needed to meet and exceed deadlines.

§Monitor productivity and provide training and instruction for superior performance.

Upfront Review Clerk – Lincare (September 2014 – December 2016)

§Responsible for translating patient information and into alphanumeric medical codes.

§Collect, post, and manage patient account payments.

§Responsible for insurance verifications, A/R payments and processing ICD-10 information.

§Process Durable Medical Equipment (DME) coverages.

§Prepare and review patient statements and submit claims to insurance companies.

§Review delinquent accounts and contact patients for collection purposes.

§Process payments from insurance companies.

§Ensure healthcare facilities are reimbursed for all procedures.

§Maintain documented information regarding patient treatment, diagnosis, and related procedures to ensure proper coding.

§provide training and instruction for superior performance.

Customer Service Supervisor – Caremark Specialty Pharmacy (March 2008 – August 2014)

§Supervise day-to-day activities of 20 customer service representatives within established policies and procedures.

§Effectively lead and motivate team ensuring all customer service needs are met in a timely manner to improve customer service satisfaction.

§Provide employees with performance feedback, proper training, and guidance.

§Collaborate with team members and other departments to ensure positive teamwork, process improvement and overall customer excellence. the care for emotional, physical, and spiritual well-being of patients by encouraging and impart coping and life skills in a safe and structured environment.

§Communicate, implement and interpret new and existing policies and procedures to department staff.

§Establish a pleasant, functional atmosphere within the department and provide leadership and mentoring to encourage teamwork and maintain an excellent report with a diverse customer base.

EDUCATION & SPECIALIZED TRAINING

§Computer Science Penn Valley Community College

REFERENCES

Available upon request

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