Customer Service Medical

Carla A. Wilson

**** ***** ***** ***** ***. ***

Raleigh, NC 27612

******.*******@*****.***/919-***-****

Profile

My communication skills (verbal and written) are superlative. I enjoy resolving client (internal and external) inquiries, billing

questions and complaints. I bring years of office and customer support experience working in fast paced environments. I adhere

to successful time management schedules; customer needs assessments, and swift ingenuity. I exercise independent judgment,

decision-making and problem solving abilities. I am always reliable, optimistic, friendly and professional.

Professional Experience

Aerotek, Incorporated/Contract Assignment-Call Center

August 2011-Present

Durham, NC

Data Collection Specialist:

I contact hospitals, private physician practices and ancillary medical providers, accessing specific candidate’s

files in order to extract information for government research. I then compile and enter this information into a

data base and send it to the appropriate departments for a government census.

I deal with multiple cases per day, a single case being the retrieval, compilation and submittal of a candidate’s

medical information. Study provider refusal converter/negotiator. The medical personnel I interact with are

very busy, therefore my polished telephone etiquette, command of the English language and diplomacy are

indeed an asset in this employment function. I am always tactful, direct and result oriented, but still able to

foster a well-rounded relationship as well. I completely understand and adhere to HIPAA guidelines. My

knowledge of medical customer service, medical insurance and terminology, medical coding (CPT & ICD 9

and) billing, as well as my call center experience has made my assimilation into this role a successful and

enjoyable experience.

Responsible for finding all possible contact methods for lost survey participants by using internet and database

resources.

Find third parties to assist in the process (potentially interview former neighbors, friends, relatives, employers

and other known contacts).

Obtain and update verified information about the location of the participant.

Make initial contact with participants once they have been located.

Data abstraction.

Document/Enter information found into a database.

6/8/2008 -8/24/2009: The Center for Orthotic & Prosthetic Care Durham, NC

Medical Front Desk /Administration:

Enthusiastically greeted patients making them feel welcomed and cared for.

Managed phone calls, maintained records of all incoming and outgoing messages, SCHEDULED MULTIPLE

APPOINTMENTS FOR MULTIPLE SERVICES., processed all faxed inquiries ( with supervisor/provider

approval), copied insurance cards, entered demographics, verified insurance coverage if directed to do so, kept

track of all patients appointments, treatment plans, rescheduled cancellations / no shows, monitored waiting

room flow, created, filed and maintained charts, collected patient payments for cash visits, deductibles, co-pays

and any agreed upon payments., balanced the ledger at the end of the day, prepared and processed the daily

bank deposit

• Reconciled /Worked Aged Trial Balance reports for 30/60/90+. Researched, created, and submitted appeals

from start to completion.

• Monitored customer account details for non payments, delayed payments and other irregularities.

• Investigated and resolved customer queries.

• Adhered to an established recovery system and initiated collection efforts.

• Communicated with customers via phone, email, and mail or personally regarding the state

of their delinquent balances.

• Resolved EOB (Explanation of Benefits) discrepancies, accurately interpreted EOB and collection report’s,

documented with precision, as required, for clarity and understood the significance of privacy and HIPPA

compliancy

• Answered inbound patient and payer telephone calls and mail concerns.

8/2007 - 6/2008 PAREXEL, International Durham, NC

Customer Service Representative:

• Represented clients on a variety of clinical-related projects via inbound and outbound telecommunication.

• Maintained excellent quality and productivity standards for all client programs.

• Adhered to program scripts, guidelines, SOPs and GCP regulations.

• Assisted other areas within the call center and fulfillment as needed,

• Provided training to contract employees ( as of 9/2007) in daily duties and responsibilities, telephone etiquette, proper

documentation, script review and word pronunciation, computer operational skills necessary to perform job function, triage

telephone calls from sites to specific Project Coordinator’s.

• Retrieved and followed up on numerous inbound voicemail and email leads.

2/2007 - 8/2007 Harris Teeter, Inc. Raleigh, NC

Cashier /Part-Time

• Accurately and efficiently operated the cash register

• Provided prompt and friendly customer oriented service

• Maintained security and control of all funds in the cash register.

2005 – 2006 MedSolve, Inc. Norwalk, CT

Medical Practice Operations/Insurance Follow-up Collector

• Expeditiously resolved insurance claim rejections and denials.

• Initiated appeals, researched and resolved client/patient remittance discrepancies. Answered telephone inquiries and email

queries from both clients and patients.

• Identified incorrect charges based on proper CPT coding and payment methodologies. Scrutinized and researched encounter

forms prior to charge entry to create as many initial clean claims as possible.

.

Education

Norwalk Community Technical College Norwalk, CT

Associate in Arts: Liberal Arts w/Mass Communication Option, Cum Laude

Certified Data Collection Specialist via Agency for Healthcare Research Quality & Centers for Disease Control and

Prevention

HIPAA Certified

1/2010-Present Crossroads Fellowship Raleigh, NC

Trained/Commissioned Stephen Minister

Stephen Ministry offers care, support and encouragement to people whose lives have been disrupted by divorce, death, grief, loss

of a job, retirement changes, health problems, loneliness, discouragement, childbirth, questions about God and faith, and so forth.

The ministry trains and supervises lay caregivers to provide confidential, one-to-one Christian care to people in and around our

church.

Stephen Ministers support people who for the most part have their basic coping skills intact, their thinking in order and their

emotions under control. These care receivers need someone to walk beside them, to encourage them, to pray with them and for

them, and to bear their burdens with them. The Stephen Minister offers his or her support through attentive, active listening and a

caring presence

Skills Summary:

Microsoft Windows XP Office

CATI Software-Voxco

ComCash Point of Sale Software (POS)

Docsurfer

QuickBooks Pro

Citrix Client

Medical Software:

Zirmed

Healthmatics Ntierprise

Med Flex

Advantx

LastWord

Novell Rapids

References Available Upon Request

Contact this candidate