Customer Service Medical

Continuous Professional

Continuous Professional

MELISSA D. WILLIAMS

*** ***** **** **• Columbia, SC 29229 • Email •abkpi7@r.postjobfree.com • Cell: 803-***-****

QUALIFICATIONS AND SUMMARY: Proven record of facilitating support and managing fast paced

operations. Strong organizational and communication skills with the ability to multi-task problems

regarding any Health Care issues. I have multitude of versatile skills transfer into any task such as medical

billing, medical hardware, medical software, EMR, patient registration, claims, and technical support.

Advance understanding of customer needs with diligent attention to detail resulting in superior customer

service and high levels of client satisfaction.

Professional Experience:

Lien Resolution Analyst: Garretson Firm Resolution Group, Charlotte, NC

2010-Present

●Call into CMS to report Medicare lien cases regarding Medicare patients

●Prepare lien letters for Medicare/Medicaid for CMS protocol

●Create Medicare/Medicaid cases preparing conditional payment letters

●Resolve final demand and dispute cases regarding all patient injuries

●Create COBC (coordination of benefit) cases and authorization for new cases

●Prepare/Resolve private healthcare liens resolving any third party business

●Provide initial training for new employees

●Audit ICD-9 codes and review claims charges

●Comply with CMS Medicare/ Medicaid laws

Client Server Analyst: Health Port, Health Information Technology, Columbia, SC

2007 to 2010

•Provide technical support for electronic medical records (EMR) or interface

•Provide advanced support for the client’s medical hardware PCs, and PC servers

•Resolve issues such as patient registration, claims, and electronic dataset, financial reports

•Provide support for client’s hardware problems, operating systems/databases

•Resolve Tier 1 and Tier 2 support assisting client documenting all calls

•Remote/Server access to client PC solving software and hardware issues

Business Office Associate: Gastroenterology, Carolina Personnel, Columbia, SC

2006 to 2007

•Input Gastroenterology procedure codes, review all office and hospital charges,

•Receive billing payments, reviewed all collection reports, post charges

•Maintain daily reports of input charges, balance payments, charges, insurance checks daily

•Resolved customer service issues, resolve billing issues, retrieve medical records,

•Assist front desk check/check out when needed.

Qualified Independent Contractor: Q2A, Blue Cross Blue Shield, Columbia, South Carolina

2006 to 2006

•Receive/Review Medicare Appeals Contracts

•Input Medicare appeals in system, QC correspondence and Medicare appeals

•Maintain and manage all Medicare appeals, compose letters, review errors for all appeals

once keyed in CMS database.

•Retrieve claims processing for Medicare B and DME claims.

Medical Biller Rep., Recruiting Solutions Employment (temporary) Columbia, SC

2005 to 2006

•Resolve all claims; edit Medicaid/Medicare errors,

•Resolve all multiple accounts posted in system.

Continuous Professional

•Maintain online commercial accounts, review and correct all Medicare accounts

•QC and keyed Hospice/Medicare split billing, customer service, and reviewing itemize bills.

Patient Financial Rep II, Carolinas Medical Center, Charlotte, North Carolina

2003 to 2005

•Assisted patients with insurance payment plans, patient records, and referrals

•Supervised and maintain patient registration staff on weekends, resolved complaints

•Develop and maintain rapport with doctors, nurses, and administration

•Interviewed and counsel patients for demographic information, charges, and fees

•Register patients, provided customer service, phone scheduling, and post charges

Patient Financial Rep I, Palmetto Health Hospital, Columbia, SC

1999-2003

•Register patients in hospital and clinic for hospital admittance

•Enter Medicare secondary Insurance questionnaire payer source for

•Provided customer service receiving incoming calls from insurance companies

•Maintain confidential reports, claims, financial transactions and charges

●Contact private insurance and Medicare/Medicaid for insurance verification

Work Flow, Acct Admin, Blue Cross Blue Shield, Columbia, SC

1994 to 1999

Work Flow Clerk, Account Administration, Medicaid Representative

• Compose Insurance contracts such as Dental, Medical, and Life

• Review all HCFA claims for errors and accuracy

• Provide Customer Service to subscribers when needed

• Research information using CRT, ATS, retrieve documents from microfilm

• Compose and created spreadsheets, reviewing and QC all contract

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Skills

Healthcare Information Systems, Companion Practice Management, Medical Terminology, Data

Entry, Microsoft Imaging System, HBO Star Navigator, Scan Link, Kodak Image, UNIX, EMR,

Electronic Data, Interface, Webex, Adobe, Technical Support, TCL, (Terminal Control

Language), EDI (Electronic Data Interchange), Programming Language, Miysis, Meditech,

Megaview, Customer Service, Health Care Law, Medicare/ Medicaid Liens, Law Base

software.

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Education

Bachelor of Science in Sociology

Coker College, Hartsville, South Carolina (2002)

Master of Health Administration

Webster University, Columbia, SC (2007)

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Volunteer

Boys and Girls Club of Columbia, South Carolina

University of South Carolina Career Health Fairs

Cure Cancer Radio-Thon of Columbia, South Carolina

Providence Hospital Sister of Charity

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Continuous Professional

Awards

Outstanding Achievement in Program Management

HIPAA Certified (Health Insurance Portability Accountability Act)

Outstanding Achievement Providing Superior Support

Magic Customer Service Achievement

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