Customer Service Medical
Resume:
Christine Bey *************@*****.***
____________________________________________________________________________
Professional Accomplished managed care professional with experience in collections;
Summary: customer service, Provider Relations Representative, HMO, PPO, network,
claim adjudication, Medicaid.
Experience 07/09 –Current Real Results, Weight loss Solution Atlanta, GA Patient
Advocate
Organize medical weight loss health fairs
Conduct interview for weight loss program with patient
On site seminars with varies community faith base organizations
• Conduct interviews with patient discuss benefits and answers any
questions and order test on road map.
• Review in detail the insurance and medical requirements and estimated
patient responsibility amounts. Provide patient with responsibility
disclosure for signature.
• Submit Pre-Authorization Requests to Insurance Carriers
• Work closely with Medical Director to obtain medical clearance and
surgery authorized by insurance carrier, surgery is scheduled
• Financial Counseling
08/08 – Current South DeKalb Center for Healthy Living
Volunteer/ Intake Coordinator
• Financial Eligibility
• Patient referral forms
• Clinic flow charts
• Train volunteers
• Health fairs
5/09 – 06/09 Children’s Healthcare of Atlanta
Customer Service/CMO Collector
Temporary Assignment
• F/U on Peach State account receivables
• Customer Service
05/2008 – 07/2008 Centene Corporation Atlanta, GA
Team Lead ( Peach State Health Plan)
Supervision of the Customer Service, and Eligibili ty
departments.
Handled calls requiring handling by a supervisor.
Monitored ACD line to ensure staff compliance of regulations.
Monitored all aspects of open enrollment including town hall
meetings.
Completed monthly QA reviews on staff to evaluate quality of
work, adherence to time and attendance guidelines.
04/2006 – 06/2008 Medical Business Service Atlanta, GA
Supervisor of A/R Rep I I
Direct Manager for the Medicare and Medicaid Departments.
Responsible for 27M A/R which span through four clients with a
combined total of 78 physicians.
Responsible for day to day management assistance of the entire
office staff of 40 employees.
Restructured the department to enhance productivity of the staff
w hich has lead to financial record breaking.
Ensured Physician’s credentials were current and notified the
compliance department when updates were due.
Established relationships with provider representatives.
Ut ilized for special audit projects for other locations to ensure
compliance with collections procedures and guidelines.
Worked hands on with the accounts to assist in follow up and
account resolution; while auditing work performed by the staff.
Directly Filed Claims on the GHP and CMO Web-Portals.
02/2005 – 04/2006 Prestige Staffing Atlanta, GA
Contract Employee
Contracted as a Review Specialist for Medical Business Service,
I nc.
Contracted to audit and clean up multiple client accounts
receivables.
H i red into the Management Team after contract expired.
9/2003 – 04/2005 Emory Healthcare Atlanta, GA
• Medicaid/ Insurance Collector
Processed Medicaid referrals through the Web Portal System
Scheduled appointments for minor patients.
Audit the system to ensure all duplicate accounts were purged
daily.
Billing and Follow up on Commercial, H MO, and PPO accounts.
Education:
Strayer University/ Chamblee Campus
Major: Associate Business Administration
Graduate date: December 19, 2011
Software Systems:
WebPortal, WebMD, AS400, UNIX, ICARE, Proclaim, IDX, and Amysis, Macess
Microsoft Office (Word/Excel/Outlook)
Lotus Notes, eClincal and Sales Forces
Provider Relations Representative, evaluation tracking and development,
claims research
Contact this candidate