Customer Service Insurance
Resume:
SHANTA W. PATTERSON
Rialto, Ca 92376
323-***-**** Home
abhgo9@r.postjobfree.com
Summary of qualifications
* *********** ************ **** *** years experience with Healthcare support, Insurance verification, Reviewing
claims and call center operations, administration and clerical skills.
2Perform duties with insurance verification reviewing benefits for coverage, correct and update all patient
accounts, payment posting, postiont payments to correct accounts, rebill and review claims.
2Demonstrate Customer service and patient inquires along with patient demographics and follow-up, Mail and
correspondence along with Pre-register patients into system.
3Talent for identifying customer needs and presenting appropriate company product and service offerings.
4Ability to improve customer satisfaction inquires with leadership and team work, excellent verbal and written
skills.
Technical skills
1Fax/ Copier machine
2Type 50 wpm
310-Key by touch
4Microsoft excel
5Windows XP
6Microsoft word
7Microsoft access
8Microsoft outlook
9EZ-cap, MM, IDX, Sap, On-track, Vista
10Medical terminology
Professional Experience
Work Experience :
PARTNERS IN DIVERCITY/VA HOSPITAL Long Beach, California 2008 2009
Insurance Verifification Specialist (2008 2009)
Responsibilities is to serve as a Insurance Verifier, call Ins companies like BCBS, Health net, Aetna, PacifiCare,
United healthcare, Medicare, commercial and private Insurance companies. Check eligibility plan type and to see if
we are a contracted provider and if patient has in and out of network benefits. Also verify if patient has inpatient and
outpatient services on their plan. Also verify for patients over 65 see if they have Medicare Part A and Part B and
update and process in the system. Make sure that all account that is processed out of the buffer everyday is
updated correctly and corrections are made correctly. Also post payments for PPO, HMO, POS, Private inssurance
companies and Medicare/Medi cal accounts and make sure refunds were issued correctly and analyze each patient
accounts for overpayments. Also pre register patients into system when needed.
HOSPITAL EMPLOYEE LABOR POOL/U.C.L.A. PYHSICIAN SUPPORT SERVICES Los Angeles, California
2008 2008
Payment Poster (2008 2008)
Served as a payment poster in the cash posting department. My duties were to post paymentsfor PPO,POS, HMO,
Medi cal/Medicare accounts in SMS System, I had to post 30 batches a daily, make sure that all batches were
balanced correctly and make sure that all receipt number were correct and the payment types for each patient
accounts were correct. Keep a copy of all posted batches for our productivity; also make sure everything was detail
oriented. In addition I also worked with the refunds, tracers and transfers to make sure that they were counted and
recorded on the log for each day and going into SMS to put in all notes for each patients account with the Dos the
amount and Insurance Company. I worked with the refund checks to see if the refunds issued were correct, and
analyze each patient accounts for overpayments.
MEDTRONIC DIABETES – Northridge, California 2005 to 2007
Customer Representative (2005 2007)
Serve as Customer Service Representative for the Insurance verification department. Perform customer service also
verify pt eligibility and benefits for Durable Medical Equipment for the Diabetic Insulin pump supplies. Call all
Blue cross Blue shield plans and Cigna, Untied Healthcare, Medicare, Medicaid and private insurance plans. Call
patients to obtain new updated insurance information when polices have canceled. Scan all online order into DMS
system. Also make sure all secure and complete orders are coded off for the day. Make sure all authorization
information obtained for authorizations needed. Follow up on all Can pending orders daily. Call insurance
companies to get eligibility and benefits for Durable Medical Equipment for the Insulin pump supplies. Call all Blue
cross and Blue Shields, Health Net, Cigna, United healthcare, Pacific care, Medicare, Medicaid and other private
insurance plans.
Customer service and the ability to communicate with customers to resolve there insurance information needed,
such as obtain the correct identification number, group number, and plan name and employer group. Follow all
contracted and non contracted decision trees for all insurance companies; see if authorization and referrals are
needed. Obtain medical group information and contact number and fax number. Make sure all claims are submitted
to the correct billing address and the correct contract number is utilized.
SPERHRION/KAISER PERMANENTE – Los Angeles, California 2004 2005
Medical Records Clerk (2004 2005)
Prepare and separate all appointment sheets and deliver appointments to all medical clinics, deliver charts before
there appointments times; Pick up charts from the clinic side and the hospital side, also re file all returned charts.
Sort out and deliver all appointments to all clinics Floors 1 4 and the Westside of the building. Deliver all
appointment charts to Internal Medicine 2a 2d, and 2e 2f, 2g 2h. Also deliver and pick up 1st floor Family
Medicine, Plastic Surgery, 1E, Physical Medicine, Orthopedics/Podiatry. Pick up and deliver charts to the hospital
side 5th floor east/west, 4th floor Oncology, Nephrology, chemotherapy, 3rd floor CCU/ICU and east/west, 2nd
floor east/west and Sigmoid and Optometry. Sort and file all returning charts to flipping station to be re file back in
order, also help patients with any inquires on there charts.
U.C.L.A. PHYSICAIN SUPPORT SERVICES Los Angeles, California 2003 2004
Senior Clerk/ Secretary (2003 2004)
Responsible for entering HCFA claims into system correctly close attention to detail, speed and accuracy, also
check claims for payments, and re bill unpaid claims. Claim Support/ Data Entry. Sort and review HCFA claims,
also arrange by letter and alphabetize and separate all claims threw divisions of CLA, MXM, MEDI Cal, SOS.
Attach authorization reports to all claims that are threw other counties. Check all claims for payments and verify
patient eligibility. Re bill unpaid claims and some secondary billing and review EOB's.
U.S.C. FAMILY MEDICINE Altadena, California 2001 2001
Billing Assistant (2001 2001)
Claims support and data entry and mail and correspondence, customer service representative. Customer service call
center. Help patients with billing inquiries and registering patient into system. Run daily mail and correspondence
and deposits. Sort and review HCFA claims to be mailed out for the day. Review fee tickets and set up word excel
for the batch reports; also follow up on patient’s accounts.
RADIOLOGHY PRACTICE MANAGEMENT Long Beach, California 1999 2000
Payment Poster (1999 2000)
Responsible for posting all payments to patients accounts, also keeping record of all posted payments. Post and
balance patient payments from MEDI Cal, PPO’S, Private Insurance, Analysis EOB’ S for contractual discounts
and prepaid accounts and set up accounts for refunds including making copies. Posting adjustments to accounts,
zero pays and running claims to bill secondary insurance. Verify and record all posted checks.
Education:
1996 1997 Santa Monica Beauty College
1999 1999 Santa Monica College
1992 1996 EL Camino Real High school
REFRENCES
Upon request
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