Customer Service Quality Assurance

Jaymie K. Williams

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

Pottstown, PA 19464

Hm 484-***-****

Cell 215-***-****

abiuc1@r.postjobfree.com

To Whom It May Concern:

I am submitting my resume for consideration for any employment

opportunities that are available within your organization.

I am an energetic team player with outstanding interpersonal

characteristics. I am capable of successfully displaying excellent verbal

and written communication, analytical, leadership and time management

abilities. I am highly organized and self motivated. I possess the

ability to maintain flexibility while working in multifunctional

environments. I am also capable of working independently and proficiently

under demanding and deadline driven conditions. I hold demonstrated

supervisory competency and strong customer and team-focused work ethics.

Attached is my resume containing my experience and qualifications for your

review. I trust and hope that you will find my qualifications suitable for

your business professional needs.

I look forward to meeting with you to discuss how my talents can serve as

an asset to your company.

Respectfully Submitted,

Jaymie K. Williams

Jaymie K. Williams

201 Jay St. Unit H92

Pottstown, PA 19464

Home 484-***-****

Cell 215-***-****

abiuc1@r.postjobfree.com

Summary: Dynamic and highly energetic Claims/Customer Service and

Collections Specialist with over 12 years experience within the Health Care

Patient Accounting and A/R Follow Up market. Extremely detail oriented,

with impeccable interpersonal, communication and follow up skills.

Motivated team player who exhibits versatility, punctuality, problem

solving and leadership abilities.

Qualifications: ICD.9/HCPCS/CPT Coding, Microsoft Office Applications, MHS,

Meditech, Navinet, HMS, Premis, Planmate, Oscar, ADHOC, Epic, Envision,

Compass, PeopleSoft, Kronos, Diad, Cisco Phone Systems, Clear Tran, Oracle,

Medical Terminology, Medical Billing, Third Party Billing, Medicare

Billing, Medical Claims Processing, Adjustments and Collections.

Experience:

Worked various temporary positions while attending college from the date of

my last position until present.

Phoenixville Hospital - Phoenixville, PA

~Insurance Verification Specialist~ January

2008 - November 2008

Review outpatient accounts for insurance verification and patient

eligibility. Collect any patient responsibility such as copayments or

deductibles that may be due at the time of service. Responsible for

obtaining precertification and referrals when needed for MRI, CT and

outpatient surgical procedures for Phoenixville Hospital Outpatient

Facility and its Wound Care Center at Limerick. Thoroughly notate

patient's account to reflect recent data and activity.

Quest Diagnostics - Norristown, PA

Kelly Staffing Services - King of Prussia, PA

~Billing Coordinator II (Temporary Placement)~ October 2007

-December 2007

Applied payments and denials of third party insurance carriers in all media

types. Interpreted Explanation of Benefits for proper calculation of

disallowance assignment of denial codes and appropriate follow up action.

Completed refunds/adjustments to customer's accounts, while providing the

necessary back-up information in order to maintain accuracy. Researched

unidentified payments to determine proper account application. Reconciled

and balanced cash batches prior to submission to support and the in-transit

log. Researched and solved batch resubmissions to ensure proper posting of

cash in a timely manner. Met or exceed daily quality & production

standards.

Iron Mountain - Limerick, PA

Solomon Edwards Staffing - King Of Prussia, PA

~Collections Specialist (Temporary Placement)~ July

2007 - September 2007

Responsible for business to business high profile collections. Made at

least 40-45 outgoing calls a day in order to maintain customer portfolio.

Facilitated bi-weekly meetings with various levels of management to

communicate issues regarding non and slow pay customers.

De Lage Landen Financial Services - Wayne, PA

RemX Financial Staffing Services - King of Prussia, PA

~Contract Specialist Contract (Temporary Placement)~

May 2007 - July 2007

Audited small and large lease and loan ticket transactions submitted by

sales department for DLL's Financial Institution customers. Communicate

discrepancies to sales support staff and credit department in order to

ensure timely booking, funding and accuracy of contract documentation.

Resolve all contractual issues prior to funding. Accurately input

transactions into system for tracking, booking, funding and customer

invoicing. Approve funding and process ticket transactions up to lease

signing authority. Address functionally related internal inquiries.

Yellow Book USA - King Of Prussia, PA

Metropolitan Personnel Staffing - Valley Forge, PA

~Final Demand Collector (Temporary Placement)~

October 2006 - April 2007

Responsible for making the final attempt to contact business advertisers

who have ignored previous collection efforts and whose accounts were in

severe jeopardy of being turned over to an outside collection agency and/or

legal litigation. Professionally emphasized the urgency of immediate

payment to prevent further collections. Identified the advertiser's

ability vs. their inability to pay and recommended the appropriate course

of action. Negotiate and authorize mutually acceptable payment

arrangements and in house settlements within company's contractual policy.

Processed credit card, check, direct debt and ACH payments by phone.

Thoroughly examined the advertiser's account payment history and other

financial documentation when making payment arrangements and/r

recommendations. Reviewed unresolved account claim issues and disputes

with customer service and or management in an attempt to maintain the

customer while eliminating the bad debt. Worked closely with internal

credit department by tracking bad debt accounts to ensure accurate approval

and denial of credit for advertising for existing and future Yellow Book

customer accounts.

Siemens Medical Solutions - Malvern, PA

~Patient Accounting Representative II~ November

2004 - February 2006

Provided valuable customer service, hospital collections, insurance follow

up and phone support to the company's Provider Relations Department.

Independently managed assigned high dollar and over-aged workmen's

compensation, no-fault and medical insurance claim accounts for three large

New Jersey hospital facilities. Followed up daily with patients, insurance

companies and law firms in order to track and maintain accounts receivable

inventory. Thoroughly investigated causes for delayed or inaccurate

payments. Submitted findings along with suggestions to management on how to

initiate alternative methods for an expedient resolution.

Independence Blue Cross - Philadelphia, PA

~Provider Claims A/R Specialist~ February

1999 - December 2002

Provided support to the Out of Area Accounting Department by resolving all

unbalanced financial discrepancies that occurred within the National

Accounts Blue Card Operations Department. Worked closely with internal and

external customers and various levels of management to ensure the timely

processing of aged, problematic and/or high dollar claims for the Out of

Area Department's premier hospitals. Served as a liaison for assigned

hospital accounts, to retrieve delinquent payments from members and

participating insurance providers of the BCBSA. Conducted onsite visits to

contracting hospitals to resolve concerns and address inquiries pertaining

to aged, problematic and/or high dollar claims. Provided assistance to

senior management with HIPPA implementation projects. Responsibilities also

include those listed under Claims QAS.

Independence Blue Cross - Philadelphia, PA

~Claims Quality Assurance Specialist~ April 1997

- February 1999

Analyzed possible duplicate claim payments and generated quality assurance

reports of error trends and findings on a monthly basis for the National

Accounts Blue Card Operations Department. Completed multiple tasks and

assignments in a high-production environment. Responsible for on the job

training for new and existing associates within the department. Served as a

backlog support for the production area with claims processing and/or

adjustments. Assisted management with special projects by providing claims

processing and/or administrative support. Temporarily served as Acting Unit

Leader for the National Accounts Blue Card Claims Processing Department.

Responsible for overseeing12-16 associates with daily production

assignments, attendance monitoring and maintaining an overall positive and

productive work environment. Performed one-on-one and group meetings with

associates. Tracked associate's performance and provided constructive

feedback and training as needed. Submitted my review to upper management

for associate's quarterly performance evaluation.

Independence Blue Cross - Philadelphia, PA

~Control Assistant~ November 1995

-April 1997

Responsible for the proper distribution of all incoming and outgoing mail.

Prepared then logged all health insurance applications onto the GRAL system

for processing. Assembled mail order kits for Health Care Administrators.

Education:

Montgomery County Community College - Blue Bell, PA

2003 - Present

Currently pursuing degree in Nursing

Manor College - Jenkintown, PA September 1994 -

May 1997

Healthcare Management

References furnished upon request

Contact this candidate