Customer Service Care Team
Resume:
Berneta D. Maison
Medical Liaison
Remote
ad5tt9@r.postjobfree.com
Professional Summary
Skilled Medical Liaison with over 10 years of experience in the healthcare industry. Strong organizational and time management skills, with the ability to handle multiple tasks simultaneously and meet deadlines. Excellent communication and interpersonal skills, with the ability to build rapport with patients and insurance company representatives. Proficient in Microsoft Office Suite and various healthcare software systems.
Areas of Expertise
Physician
Credentialing
Insurance Claim
Review and
Processing
Medical Billing and
Coding
EMR Data
Microsoft Office
Suite
Written and Verbal
Communication
Process
Improvement
Customer Service
Professional Experience
US Veteran Administration, Hampton, VA - Advanced Medical Support Assistant
JANUARY 2023 - PRESENT
● Act as point of contact for patients with questions regarding their insurance coverage — making referrals for healthcare services and providers as needed.
● Work collaboratively in an interdisciplinary coordinated care delivery environment (i.e., patient aligned care team, or other specialty care.
● Coordinate with the patient care team to review the clinic utilization by using various reports (e.g., Clinic Utilization Statistical Summary).
● Develop/maintain effective and efficient communication with the patient, interdisciplinary team, management team, VA medical centers, and other agencies.
United Healthcare, Remote - Patient Advocate
JUNE 2022 - JANUARY 2023
● Served as the general resource of Medicare Advantage and Retirement Benefits information for members in Georgia, Alabama, and Illinois Teachers Union so their questions were answered and concerns addressed without frequently interrupting the workflow of other areas. Whole Family Wellness Center, Chesapeake, VA - Front Office Administrator/Registered Medical Assistant (Part-Time) SEPTEMBER 2019 - SEPTEMBER 2023
● Verified insurance eligibility and billing claims utilizing online platforms or by contacting the carriers directly.
● Implemented care and efficiency improvements to support and enhance office operations.
● Scheduled appointments, registered patients and distributed sample pharmaceuticals as prescribed.
Maximus, Hampton, VA - Eligibility Specialist
SEPTEMBER 2017 - SEPTEMBER 2018
● Reviewed applications for Kansas Medicaid to determine eligibility — following up with applicants as needed regarding missing requirements.
● Primary contact for applicants — answering any inquiries and concerns and escalating as needed.
Aetna, Highpoint, NC - Claims and Benefits Specialist/Schedule Adherence Supervisor
MARCH 2013 - JANUARY 2014
● Analyzed and resolved routine pharmacy claims that could not be automatically adjudicated by Aetna’s computer software.
● Applied medical necessity guidelines, determined coverage, completed eligibility verification, identified discrepancies, and applied all cost containment measures to assist in the claim adjudication process.
● Monitored agents to measure productivity and improve operational efficiency by ensuring agents complete calls within the allotted time according to company policies.
Education
Strayer University, Newport News - Business Administration and Medical Administration (BS)
Anticipated Graduation Fall 2023
Medgar Evers College, Brooklyn, NY - Science (AS)
1995
The New York School for Dental and Medical Assistants, Forest Hills, NY
1994
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