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Customer Service Call Center

Location:
Columbus, OH
Posted:
July 13, 2023

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Resume:

ELEANOR BELCHER

*** ****** **., *********, ** ***03 614-***-**** adyakp@r.postjobfree.com

PROFESSIONAL PROFILE

Well-rounded professional who offers extensive medical industry experience. Pays attention to detail to review and correct errors and ensure high levels of accuracy. Develops effective communication in order to promote a positive work environment and optimal operational workflow. Maintains patient privacy and confidentiality.

Academic Honors Recognition / Honor Roll.

Experience in Microsoft Word and Excel; Typing Speed: 85 wpm & 10-by touch – 15,000 ksph

Problem solver; combines judgment and experience to create sound solutions. KEY QUALIFICATIONS

Practice Structure Leadership & Management Medical Terminology Business Office Operations Medical Office Procedures HIPAA Compliance Anatomy & Physiology Human Resource Management Organizational Improvements Practice Management Software Electronic Health Records (EHR) Electronic Medical Records (EMR) Greenway Healthcare Computer Information Systems Medical Practice Management Systems Accounting, Payroll, and Banking Systems Healthcare Law Insurance Billing Procedures Healthcare Claim Cycle Insurance Verification

Maintaining Prescription Line Appointment Scheduling Charting Filing Processing Co-Payments EDUCATION

Ultimate Medical Academy Associate of Science Degree – Healthcare Management, 2016 Everest Institute of Technology Medical Insurance Billing and Coding Certificate, 2006 MEDICAL EXPERIENCE

Startek/Medica Insurance, Mansfield, OH 12/2019 – 03/2020 Customer Service Billing Representative

Post payments of premium for customers

Call center setting – explain Marketplace subsidies & credits, adjustments

Explain monthly premium when different than estimated by government University Hospitals – Good Samaritan, Ashland, OH 07/2018 – 10/2018 Customer Service Billing/Revenue Cycle Specialist

Contact and follow up with patients via phone and/or letters to collect on self-pay balances through assigned work queues or reports

Take incoming phone calls from patients or others and assist in resolving accounts

Negotiate payment arrangements with patients

Transfer accounts to collection agencies for bad debt and payment plans

Fax claims to insurance companies for processing

Send letters to patient’s for info needed to process claim

Re-bill claims that have been lost, rejected or errored

Verify insurance information

Use credit card machine to process patient payments

Follow-up with insurance companies

Answers emails on the same day or the next business day Centene Corporation, Buckeye Health Plan, Columbus, OH 06/2015 – 11/2016 Program Coordinator I

Used computer to enter data assessments and authorizations into the system.

Initiated authorization requests and maintained prior authorization list.

Screened eligibility and benefits; coordinated services with community-based organizations. Program Coordinator 1

Worked with nurses to ensure a well-established health plan for members.

Answered phones and assisted members with waiver services; updated member information.

Managed reporting of patient information and provided to managers. Molina Healthcare, Columbus, OH 02/2015 – 06/2015

Care Review Processor

Abstracted clinical data to assign CPT, ICD-9, and HCPCS codes.

Researched and made corrections to denied or rejected claims from third party payers. Columbus OBGYN, Columbus, OH 08/2013 – 11/2013

Medical Biller

Entered data electronically to process charges, payments, denials, and adjustments.

Resolved routine billing issues and inquiries; followed-up on balances due from insurance companies. Contract Work for Nationwide Childrens Hospital/Firstsource Solutions/ Careworks/ HMS, Columbus, OH 03/2009 – 01/2013

Medical Biller / Caseworker / Patient Account Representative/Account Resolution Specialist

Entered data into charge capture system for export to billing system.

Posted payments, corrected errors, and re-submitted claims.

Contact patients regarding accounts 30-90 days past due.

Contact insurance companies regarding overdue payments.

Worked with UB-04, UB-92 and CMS-1500 electronically and manually.



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