Customer Service Manager

**** ******* **** ***** 502-***-****

Louisville, KY 40291 Mobile 502-***-****

E-mail abi9xn@r.postjobfree.com

Rita Thompson

To obtain a challenging and rewarding position with a company where prior experience, personal

Objective ability, and a commitment to professionalism would be of value. Position should allow for continued

personal and professional growth.

June 08 to May 09 Avoca Physician Billing Group Louisville, KY

Work Experience

Provider Enrollment

Support the billing staff and clients in facilitating the enrollment of providers with the various

government and commercial healthcare payors and third party billing entities that require provider

enrollment. I prepare applications for all new providers; submit applications to payors, track and

follow-up to obtain provider numbers. I use credentialing software to keep all provider credentials

updated and submitted for re-credentialing purposes. I work with the billing staff for applications and

system updates, and build relationships with regional payors to facilitate enrollment and update

company spreadsheet with payor participation.

January 07 to June 08 SHPS Louisville, KY

Medical Panel Liaison

Medical Panel Liaison/Clinical Administrative Support associate I work as an important part of a

team of health care professionals who provide telephonic care to employees and family members of

our clients. My administrative responsibilities will help facilitate the smooth operation of a Telephonic

Nurse unit as you work closely with our nurses, clients, and outside healthcare providers and

perform the following functions.

Assist Health Care Advocate with outbound calls for concurrent review cases to request clinical and

obtain/verify discharge dates.

Assist Health Care Advocate with patient appeals process, including copying medical reports

coordination of mailing information and tracking of timeline to assure compliance to DOL/ERISA

requirements.

Manage overflow calls from Health Care Advocate and incoming calls including triage to appropriate

Health Care Advocate, assist member as needed or set up cases as applicable.

Facilitate delivery and receipt of mail/faxes, to all Health Care Advocates and other nurse unit team

members.

Assist with timely response to returned mail: obtain current mailing addresses and reprocess the

information to the member/physician/facility or provider as applicable.

Assist with follow-up calls for verification of lab results appointments with Health Care Advocate and

request for information.

Set up cases for initial calls and/or from ETUMS (Electronic Transmission of Utilization Management

requests) based on standard trigger diagnoses list and forward to Team Lead for nurse assignment.

Obtain missing telephone numbers for cases, update case with current information and notification

to Health Care Advocate of update.

Manages filing of Medical Records including case documentation of clinical received and/or filed,

manage medical records log onsite and offsite tracking record.

August 2005-January 2007 ProSperus Revenue Management Louisville, Kentucky

Provider Enrollment

Support the billing staff and clients in facilitating the enrollment of providers with the various

government and commercial healthcare payors and third party billing entities that require provider

enrollment. I prepare applications for all new providers; submit applications to payors, track and

follow-up to obtain provider numbers. I use credentialing software to keep all provider credentials

updated and submitted for re-credentialing purposes. I work with the billing staff for applications and

system updates, and build relationships with regional payors to facilitate enrollment and update

company spreadsheet with payor participation.

Administrative Assistant

Look up surgery logs and make corrections for times entered by charge entry. I also batch work for

coders, charge entry and payment posting. I also relieve switchboard and do spreadsheets, filing

and general clerical work, copying files, medical records, and EOB‘s for review. Assisting posting,

charge entry and coders departments with requests for all insurance purposes. Make daily run to

hospital to pickup anesthesiology charges and schedule. Take credit card payments to finance

department to be processed.

March 2006 Licensed Real Estate Agent- Century 21 Realty Group-Hagan Louisville, Kentucky

12/2001-4/2005 Sprint PCS Louisville, Kentucky

Technical Service Representative/Inventory Manager

Move, maintain and track inventory for retail sales floor. Operate Sprint PCS Systems: CIM, PSTs,

P2K and POS. Prepare reports for the retail store manager and BPA. Receive, scan and enter

inventory into the store system (CIM) and inventory space. Recommend and process customer

equipment for repairs on-site and through equipment repair and warranty processes. Ship

equipment to manufacturers or repair facilities. Test and evaluate repaired equipment, handsets,

and batteries. Troubleshoot wireless equipment for customers in retail store. Ensure inventory

security. Maintain calibration on all diagnostic equipment, adapters and connectors.

12/1996 - 10/2001Cingular Wireless aka BellSouth Mobility Louisville, KY

Technical Specialist

Responsible for first-line communication with customers by isolating and analyzing problem(s) with

the mobile unit, system operations or newly developed services. Interfaces and communicates with

RF and Field Engineers to isolate and correct problem(s). Utilizes basic technical manuals and

circuit diagrams. Interfaces, via terminal emulation's with various cellular switches to determine and

correct a variety of problems. Assist in providing support to the roaming customer base. Provides

coverage in monitoring 24-hour cellular system performance via remote monitoring equipment.

Customer Operations Assistant Manager

Performing a number of functions related to the provision of customer service from the point a

prospective customer indicates contact with a distribution channel until the customer no longer

subscribes to the service. Answers general questions about cellular phones or phone use, welcomes

customer, verifying credit of potential customers, collections of past due accounts, or any other area

of customer operations. Am responsible for the Presidents program in which customers are

rewarded for their loyalty.

11/1993 - 12/1996 USA Mobile Communications Louisville, KY

Retail/Resell Billing Specialist

Performing a variety of functions related to the provision of customer service from the point a

prospective customer indicates contact with a distribution channel until the customer needs have

been met. Am responsible for setup of accounts both Retail and Resell billing codes designed for

specific customer programming and numbers setup for pagers, report generation, collections of past

due accounts and any other customer service related areas.

Contact this candidate