Customer Service Representative

Summary of Qualifications

Medical Billing Processor / Customer Service Representative utilizing

strong computer, interpersonal and communication skills for health care

organizations. Provides excellent customer service; resolves problems and

issues assuring 100% Customer Satisfaction.

( Revenue and project driver with specialized expertise in capturing

optimal revenues with a high degree of accuracy and attention to

detail

. Credit and collections routinely corresponding with patients, vendors

and agencies in the pursuit and redemption of unpaid bills.

( Expertise includes complex claims, claims processing & adjusting,

overpayment recovery, 3rd party provider relations, organization

planning, direction, and business operations and procedures

( Professional demeanor, able to communicate with executive management,

customers, employees and vendors

( Highly organized, reliable, energetic, and possesses excellent oral

and written communication and in a fast-paced health care organization

( Exceeds expectations in responding to changing situations and

reprioritization of work with a high degree of discretion and

confidentiality

. Software: Microsoft Office (Word, Excel, Outlook); Quest Diagnostics

Proprietary CRM

Employment History

Private Contractor, Palatine, IL 2010 to Present

Provide temporary services on various short term for different agencies.

. Patient Account Billing Support (Since 2011)- Provide office support

between patients, insurance and providers; while looking for full time

regular employment.

. Fasteners Plus (Since 2011)- Receptionist / Customer Service

Representative. Provide office support, quotes for customers and

outward bound communications to new and prospective customers.

Garden Fresh Restaurant Corp (Sweet Tomatoes), Glenview, IL 2012 to

Present

Serving and doing the things that people eat in a rest

. Dining Room Assistant - Train crew members according to procedure

company policy. Customer service and communication between customers

and Management issues that may arise. When restaurant closes proceed

to close down stations for next day shift.

Quest Diagnostics, Inc. Wood Dale, IL 1990 to 2010

The world's leader in diagnostic testing, information, and services

Billing Coordinator II (2000 to present); Billing Coordinator I (1990-

1999)

( Achieves production goals by accurately and appropriately

posting and analyzing insurance payments and discounts to patient

accounts by keying payments from the EOB, researching and correcting

problem claims, restating claims when necessary, balancing and closing

the batch, ensuring compliance standardization for all work performed

requirements

( Communicates with patients, insurance carriers and clients when

difficult situations arise and handles the most complicated telephone

calls

( Maximizes productivity through proficient use of various

software programs and reference tools

( Participates in Quality Assurance (QA) process from initial

receipt of bills through final payment; conducts audits of invoices,

statements, or requisitions as needed; assists with data retrieval and

questions during audits

( Contributes to high priority projects while maintaining monthly

posting goals

( Trains and develops associates to meet the demands of the

business and provided leadership through direction, coaching, and

"moral building" team meetings

( Reviews procedures and contributes to the development of new

improvement methods to speed customer response time, paperwork flow,

and overall improvement in the running of the department

( Performs extensive interfacing with patients and third party payers

(Medicare, Medicaid, HMOs, PPOs, and private insurance carriers) to

determine validity of bills and best methods of collection

. Identifies, analyzes and resolves patient questions, problems and

billing errors conducting trouble-shooting and follow-up with all

parties to resolve payment reimbursement problems

( Prepares and distributes status reports for office management

( Monitors and records daily production and backlogs

SIGNIFICANT ACCOMPLISHEMENTS

o Completed more than 11,000 claims throughout tenure

o Recognized for effectively resolving hundreds of investigations to

successful conclusion, involving missing payments by our various

insurance vendors, resulting in proper credit to patient accounts

o Quality rating of 94% from 2006 - 2010, exceeding the departmental

goal of 85%

Wohler's Insurance Agency, Park Ridge, IL 1987-1990

Customer Service Representative

( Provided new and existing clients with rate quotes, explanation

of coverage's, and payment plans

( Promoted smooth flow of communication with all agency and

represented company personnel

Areas of Expertise

Patient EOB Interpretations Electronic processing of payments

Missing Payment Audits Health care provider relations

Posting of Insurance Payments and NextGen Healthcare Systems

Rejections

Departmental organization, planning, direction, and operations

Volunteer Experience

SuperSibs! . Palatine, IL 2011 to Present

Serving siblings of children with cancer

Volunteer - Provide office support for the organization.

Education & Training

Triton College, River Grove, IL

Business, Childcare & General Education Coursework

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