Customer Service Health Insurance

CHARLOTTE S. FUNCHES

**** ***** ***** **, *********, CA 90028: Phone: 617-***-**** Email:

****************@*****.***

SKILLS

Applications: MS Word, Excel, Outlook, PowerPoint, and Internet Research

Operating Systems: Microsoft Windows 98, 2000, XP, MAC

Beth Israel Dermatology & Laser Center/ KNF&T Staffing Chestnut Hill, MA

April 2013- July 2013

Practice Assistant I

. Greeted patients and visitors in a manner that demonstrated courtesy,

service, respect and privacy. Served as a central communication source

in the delivery of patient care by being responsive, accessible and

visible.

. Provided accurate information, directions and/or guidance and followed

up promptly to ensure that needs have been met.

. Performed check in, registration, scheduling, verification of

demographic information and fiscal data utilizing a computer system.

Collected co-payments following standards for managing copayment

processing.

. Scheduled, rescheduled and cancelled appointments making every effort

to accommodate patient and provider needs. Obtained and entered

referrals.

. Facilitated timely flow and proactively solved flow issues (i.e.,

early or late patient, late provider, etc).

. Acted as liaison between patient and practice staff to ensure optimal

flow and service delivery.

. Contacted the appropriate departments when repairs or services are

needed and followed through.

. Conducted confirmation calls necessary for follow-up appointments.

Brigham & Women's Physicians Organization Brookline,

MA May 2008- July 2012

Provider Enrollment Specialist

. Ensured the timely enrollment of new providers with 3rd party payors;

and maintenance of existing active physicians.

. Accountable for overseeing and for directly updating provider data in

CAQH system, as necessary.

. Submitted termination requests to all health plans in a timely manner.

. Produced weekly enrollment reports.

. Ensured the timely enrollment of new providers with the governmental

payors including but not limited to Medicaid/ care.

. Responsible for all the on-going maintenance of existing providers

including but not limited to the submission of maintenance forms to

update personal and practice demographic data for providers, billing

updates.

. Inputted provider enrollment information into IDX, MSO and Provider

Enrollment Database systems; and distribution of information to

designated department representatives and credentialing and

administrators.

Blue Cross Blue Shield / PSG Staffing Group Boston,

MA Nov 2007- Apr 2008

Member Service Representative / Enrollment Processor

. Answered questions regarding client's health insurance coverage.

. Coordinated internal activities to research and resolve inquiries.

. Inputted insurance verification forms into the BCBS systems.

. Promptly and accurately processed enrollment transactions in

accordance with the "CMS" guidelines.

. Provided high quality customer services to perspective members as well

as all active members.

. Tracked and maintained all levels of inventory and follow up on any

inquiries.

MBTA

Boston, MA Aug 2006 - Oct 2007

Customer Service Agent

. Responsible for the sale of Charlie tickets and educating first time

riders on how to use the system.

. Coordinated ticket adjustments, refunds processing, and ordering and

maintaining inventory of ticket stock.

. Served as the customer's primary point of contact for ticket sales,

transit information and MBTA issues.

EDUCATION

Fisher College Boston,

MA May 2002 - Aug 2006

Bachelor of Science degree in Management, May 2006

Associate of Science degree in Management, May 2005

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