Customer Service Assistant

Christine Evanado

Supervisor, Operations Analyst, Reimbursement, A/R, Service Excellence

Gresham, OR / 503-***-**** / Email: ********@*****.***

“Your biggest assets are your customers and employees. Listen to their ideas and implement them.”

How the Wise Decide

I’m a very productive worker with 11+ years of experience leading a results-driven and efficient team. Focuses on leadership, develop

and implement key strategic initiatives that promote profitability for the company. Have success in management, billing, training,

communications and process improvement.

Education:

Bellevue University: June 2010: B.S. in HealthCare Management: GPA 3.8

Technical Skills:

• Proficient: Facets, Worksight, AIM, GE Flowcast, Centricity EMR, Mckesson; HBOC STAR, PIMS, Laserarc, Microsoft Office

Suite

• Highly analytical for resolving, identifying, improving, and streamlining easy to read work process

Qualification Highlights:

• 11+years healthcare experience- 5 years hospital/clinical, A/R, claims, billing, 6 years supervising/training staff

• Strong leadership and problem solving skills, BRITE Employee (Behaviors Resulting In Team Excellence)

• 7 years of progressively responsible medical claims experience, 2-7day turnaround processing time after received date

• Experience in system development and implementation in a timely manner, provide direction and leadership to staff

• Action oriented; with excellent communication, organizational and strategic agility

• Managed team to optimize productivity, job satisfaction, and skills development

• Identify potential process improvements, design, implement and document new processes more efficiently

• Hire, train, coach, motivate and evaluate staff; identify additional training needs

• Can individually post $1Million+ payment of insurance daily (paper/ERA EOB)

• Coordinated multiple projects directed toward strategic business/objectives, excellent attendance

• Received multiple Employee Of The Month awards in Productivity, Team Spirit, Creative idea, and Customer Satisfaction

• Implemented new workflow processes to help reduce A/R days from 56 to 28 days for the Physicians Billing Dept

• Acted as a liaison between claims admin, provider, member, health plan, and other departments

• Extensive knowledge and understanding of medical terminology, CPT codes, ICD-9

Professional Experience:

Operations Analyst: Providence Health Plans (February 2011-Present)

• Lowered call volumes by providing superior service in customer service, claims, and membership accounting

• Call resolution in under 2-3 minutes, patient verification, coordinates training where there is skill deficit

• Serve as a point of contact for the customer experience associated with any care within the facility

• Independently initiates and identifies business needs, operations, cost effective solutions and functionality

• Supports managers and leaders in the resolution of operational problems and in identifying resource and system needs

• Develop improvement strategies in conjunction with service lines, ancillary and business operations

• Explained detailed benefit summaries, eligibility, and premium information on a broad portfolio of products

• Quickly responded to claims inquiries and resolve members issues/concerns

• Significant collaboration with providers, other health plans, clinics, third party administrators, and delegated vendors

• Taking the lead to draw others together to problem solve, prepare and present creative ideas

• Process all claims, including corrections/Provider refund or overpayments

• Makes solid decisions about team processes and day-to-day work

Supervisor; Patient Account Applications: Providence Health and Services (February 2006 – January 2011)

• Provided supervision and ongoing training for 20+ employees, exceeded monthly posting goals by $1+millions

• Mentored and encouraged staff how to best practice in time management, communications, work process, and goal setting

• Met with team members to review actual metrics against benchmarks

• Monitors workflow and ensures that claim turn-around times and accuracy standards are met

• Ensures payments are posted in an accurate manner to optimize reimbursement and minimize bad debt

• Perform periodic audits and communicate outcomes in a clear, concise and efficient manner

• Analyzed complex technical documents; drive the documentation, update, and implementation of workflows

• Independently presented easy to read workflow information to subordinates and management level staff

• Identified inconsistencies and redundancies in data entry system- saved time and money for employer/employees

• Participates in the testing of new software/system upgrades

• Carries out company’s mission, core values and is committed to service excellence to our patients/peers

Reimbursement Analyst: Columbia United Providers (November 2010 – January 2011)

• Responsible for implementing and maintaining provider/facility contracts and fee schedules

• Ensures claims get paid according to contractual agreements

• Run Access and GE/IDX queries

• Maintain GE/IDX dictionaries and claim issues tracker

• Regularly monitors unpaid/underpaid and denied claims to ensure that they are brought to full resolution

• Performs and completes work assignments effectively with very minimal direction/supervision

• Knowledgeable in hospital accounting system, audit processes, cost reporting, spreadsheets, presentations

Accounts Receivable Specialist: Providence Health and Services (August 2005 –February 2006)

• Accurately posted AR transactions, payments, adjustments, recoupment’s, refunds, and write-offs

• Exceeded productivity benchmark, patient registration

• Responsible for reconciling deposits with batches

• Ability to read and comprehend EOB/Remittance advice from all insurance carriers

• Researches discrepancies and applies debits/credits necessary

• Assist in month end closing; ensuring all is posted in a timely manner; working overtime and on weekends

• Resolve customer disputes and past due balances through performing of collection calls and letters

• Review, research, and respond to written letters and inquiries from customers/insurance carriers in a timely manner

• Answer release of information and AR related telephone calls

• Took on additional office duties, main point of contact

• Awarded as Employee Of The Month several times in high dollar collection, positive attitude and attendance

Certified Nursing Assistant: Providence Health and Services (October 2004 – August 2005)

• Provided basic patient care

• Documented assessment information, and assisted in the maintenance of a safe clean environment

• Respected the privacy and dignity of others; knocks before entering treatment area

• Supports and contributes to a preventative health approach

Certified Nursing Assistant: Adventist Medical Center (October 2003-September 2004)

• Provided basic patient care

• Documented assessment information, and assisted in the maintenance of a safe clean environment

• Respected the privacy and dignity of others; knocks before entering treatment area

• Supports and contributes to a preventative health approach

Mental Health Therapist Assistant: Woodland Park Hospital (September 2002 – October 2004)

• Provided assistant care to adult patients- ensuring their needs and therapeutic goals were met

• Protected confidentiality of patient and business information

Office Coordinator: Menlo Park Healthcare (January 1999- October 2002)

• Organized and implemented the facility activity program for over 20+ elderly patients

• Patient registration

• Set up and maintain financial files for residents: billing, admission papers, state and Medicare reimbursement documents;

coordinate and collect accounts receivable and past-due accounts

• Awarded as Employee Of The Month several times

My long term experience in the healthcare industry has taught me how to work well with a team, with a purpose/vision to learn and

change what we could -to make a better decision next time. Most importantly I have the tenacity and passion to work. I am flexible,

very willing to be educated in a new area and I have the mind set to go faster, harder, and more aggressively in my daily work processes.

Contact this candidate