Customer Service Administrative Assistant
Resume:
Margaret Grant
Email: ********@****-****.***
Address:
City: Westbrook
State: ME
Zip: 04092
Country: USA
Phone: 207-***-****
Skill Level: Any
Salary Range:
Primary Skills/Experience:
Experienced Medicare managed care Provider Relations Representative with experience managing physician's offices which gives me a unique perspective in understanding the day to day functioning of an office.
Educational Background:
High School Dipolma from Lane Community College, Eugene OR 1/2001 to 6/1990 (Mathematics)
Job History / Details:
Career Focus
Experienced Medicare managed care Provider Relations Representative with experience managing physician's offices which gives me a unique perspective in understanding the day to day functioning of an office.
Summary of Skills
Microsoft Office Products
Problem resolution
Multi-Task Management
Ability to travel
Claims analysis
Results oriented
Reliable
Ability to relocate
Accomplishments
Trained over 100 individuals in the Arcadian Online System
During the 2011 HCC chart collection project, I supervised a team of temporary staff in the scanning and uploading of charts to a shared drive, and also organized and maintained my teammate's progress of collecting 3,500 charts.
Resolution of ongoing claims issues for Maine Medical Partners, Maine Medical Center and Goodall Hospital
Professional Experience
September 2009 to Current
Northeast Community Care/Arcadian Health Plan South Portland, Maine
Provider Relations Representative
Serve as primary contact for providers serving as a liaison between the provider and the health plan
Conduct meetings with the providers, as required, documenting discussions, issues, attendees, and action items researching claims issues on-site and/or following up after internal research
Receive and respond to external provider related issues
Initiate changes of provider related database information and oversee testing and completion of change request in conjunction with data configuration
Investigate, resolve and communicate provider claim issues and changes
Educate providers regarding policies and procedures related to referrals and claims submission, web site education, and problem solving
Perform provider orientations, including writing and updating orientation materials
Perform new member orientations including writing and updating orientation materials.
March 2009 to September 2009
Andrew J. Candelore, DO Scarborough, Maine
Office Manager
Ensures practice employees and providers are providing the highest level of customer service to both internal and external customers.
Responsible for staff scheduling, development and performance management.
Processes payroll, accounts payable, inventory and supply management.
Continually looks for ways to improve the service, quality and processes that support quality patient care and operates in a financially responsible manner. Stays abreast of advances in healthcare and practice management including best practices.
Responds to and resolves patients' issues in a timely, professional and kind manner.
Delegates appropriate tasks, assigns department workers to specific tasks as necessary. Monitors to ensure tasks are completed on a timely basis and within established procedures and safety conditions. Provides back up support for office and administrative roles as needed.
Maintains documentation in an up-to-date manner. Prepares reports and submits as required.
Responsible for provider credentialing and ensuring all licenses are up to date.
Inspects the office to ensure clean, orderly and attractive conditions.
Attends meetings and conferences as required.
Performs other related administrative, managerial and technical duties as directed or as responsibilities necessitate.
6/06 to 3/09
Carl J. Schuler, DO Windham, Maine
Medical Secretary
11/04 to 6/06
Daniel M. Merson, DO Portland, Maine
File Clerk/Receptionist
July 2003 to September 2004
American Express Scarborough, ME
Receptionist/Administrative Assistant Financial
March 1997 to March 2000
Portsmouth Internal Medicine Association Portsmouth, New Hampshire
Receptionist/Medical Secretary
Education
1990 Lane Community College Eugene, Oregon
Associate of Science
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