Customer Service Insurance

Ione Couch

Email: ********@***********.***

Address:

City: Three Springs

State: PA

Zip: 17264

Country: USA

Phone: 814-***-****

Skill Level: Any

Salary Range:

Primary Skills/Experience:

I am a results-oriented person with excellent organization, communication and relationship-building skills. I have worked in a call center environment and I am very skilled with working with a diverse group of people. I have a strong work ethic and have a very professional demeanor. I an able to multi-task effectively. I am hardworking, detail oriented and dependable. I have an outstanding verbal and written communication abilities.

Educational Background:

High School Dipolma from Parkway Program, Philadelphia PA 1/2001 to 6/1975 (Academic)

Job History / Details:

Career Overview

I am a results-oriented person with excellent organization, communication and relationship-building skills.

I have worked in a call center environment and I am very skilled with working with a diverse group of people. I have a strong work ethic and have a very professional demeanor.

I am able to multi-task effectively. I am hardworking, detail oriented and dependable. I have outstanding verbal and written communication abilities.

Skill Highlights

Self-starter

Deadline-oriented

Microsoft Office

Insurance eligibility verification

Courteous demeanor

High customer service standards

Professional Experience

July 2011 to December 2011

Lloyd Temporary Staffing Long Island, New York

Medical Scanner Technician

The medical services client was located in Pittsburgh, PA and hired Lloyd Temporary Staffing to get employees to visit physician's offices throughout Huntingdon and surrounding counties to scan/copy medical records for auditing. I was working without a direct supervisor and followed all directions in accordance to HIPPA rules. I traveled to each location with a laptop and portable scanner. If a facility was large I worked as a team with another Lloyd Staffing employee. Once I returned home I completed Excel forms and uploaded the records before my deadline.

February 2009 to April 2011

AHS Chambersburg, PA

Billing Representative

In a call center environment I assisted with answering calls from patients of various clients that AHS does the medical claim billing for. I worked an adjusted schedule so that west coast clients could benefit from a live customer service rep and locked up the building and was the go to person for the cleaning staff.

Most times I answered questions regarding a patient's statement that gave their balance, however, I also researched denial information, corrected unpaid claims and resubmitted those claims to insurance companies. I appealed all denied claims and identified accounts for write-off.

Additionally, I contacted facilities for information required by attorneys and insurance companies, corrected patient statements, and mailed them out to patients, tracked down payment information via website, telephone, email and regular mail. All of my activity was documented in a clear and precise manner.

March 2008 to October 2008

Merion Publications King of Prussia, PA

Customer Service Representative

In a call center environment I received calls from magazine subscribers. The call was usually in regards to renewing their subscription or to make an address change. Daily I would receive subscription cards via regular mail or email and enter all subscriber demographics in the computer's database between calls. Occasionally, I received magazines that were returned and would call the subscriber to get the correct mailing address and correct the information in the system. I would then re-mail the magazine.

August 2007 to January 2008

RJR/Rotech Pottstown, PA

Customer Service Representative

Initially I was hired to greet customers who dropped off their rented equipment and to call customers who purchased CPAP machines from this company. When calling a select group I would explain to them that their insurance would pay for CPAP supplies several times a year.

I would verify their mailing address, their insurance and schedule an in home appointment with our respiratory therapist. I would enter all information in the computer and then place an order with Rotech's Durable Medical Equipment company. I pulled charts for all of the appointments scheduled with the respiratory therapist. I was responsible for contacting the physician of each customer to get an order (prescription) for any equipment so that it could be sent with the insurance claim.

If a claim was denied I would get the documentation needed and re-bill. As time went on I answered the telephone, set up oxygen deliveries and fulfilled DME orders. Additionally, I also entered all of the pertinent information so that the insurance companies could be billed for the DME equipment.

March 2007 to August 2007

HFMI Pottstown, PA

Patient Account Representative

HFMI was my employer, however, I worked out of the Pottstown Memorial Medical Center. Using HFMI's software calls were placed to patients who had a balance. I would take credit card payments, collect money in person and also get insurance information. I would send out receipts for payments received and email the PMMC staff of any insurance changes. I also did insurance verification. My shift was also responsible for interviewing patients who came to the emergency room and owed a copay or deductible. I was to make payment arrangements if they did not have this with them. I also interviewed patients with no insurance and assisted them in filling out a Medicaid application.

I assisted patients with an explanation of either their statements or their EOB's. Meticulous documentation was made for each call.

July 2005 to March 2007

SelectMedical/NovaCare King of Prussia, PA

Customer Service Rep - Medical Claims Billing

During this time period I was working here a second time. Using a report generated by the computer and placed in a spreadsheet I made calls to patients and insurance companies regarding balances owed. Letters were sent to patients regarding realistic payment plans. Balances owed due to Workers' Compensation were identified and calls were made to attorneys regarding the progress of the hearing/case. Each call was documented.

If the insurance company asked for records a call was made to the physical therapy center and I would have the records faxed to me and send them along with any other documentation that was needed. If an error was made regarding to the copays that patients paid versus what was actually shown I would do the research and make the correction. The patient would then have another statement mailed out to them.

December 2004 to August 2005

Siemens/Zavata Malvern, PA

Medical Claims Billing

I researched denial information, corrected unpaid claims (the bulk being denied for children who were added late to plans and the complex billing for transplant surgery) and resubmitted to insurance companies in a timely manner. I contacted facilities for information required by attorneys and insurance companies. I tracked down payment information via website, telephone, email and regular mail. I documented all activity, appealed all denied claims and identified accounts for write-offs.

February 2002 to December 2004

SelectMedical/NovaCare King of Prussia, PA

CSR/Medical Claims Billing/Call Center

Was hired initially for the call center. I answered calls regarding a patient's statement they received. Patients would give billing information and a form would be filled out and given to the Team leader. Occasionally a patient would have a question about their bill or a complaint and that would also be handled by the person who answered the call.

After a month I was promoted to correspondence/research. Each document I was given would need some sort of research to determine the problem and to solve it. Most times a person wrote in a complaint about their balance. If I was unable to solve this situation I would make a copy of the correspondence and give to the applicable biller for that region. Some times the correspondence would be a complaint about the service they received. I would contact the center manager and forward the correspondence to him/her. In time I became a follow-up biller and would re-bill claims that were denied once I found out why they were denied. I also did self-pay balances. I called patients to get a payment arrangement and after a time, if unpaid, the account was sent to collections.

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