Customer Service Manager

McArthur Clark

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

Address: **** ******* *****

City: College Park

State: GA

Zip: 30349

Country: USA

Phone: 404-***-****

Skill Level: Entry

Salary Range: $50,000

Willing to Relocate

Primary Skills/Experience:

See Resume

Educational Background:

See Resume

Job History / Details:

MCARTHUR CLARK, MBA

6425 Ashdale Dr. College Park, Georgia 30349* ************@*****.**** (C) 404-***-***** (H ) 678-***-****

SUMMARY QUALIFICATIONS

Patient Relations Management - Eight (8) years of experience managing and instructing patient relations activities for acute facilities. Serving as the lead advocate for patients rights and overseeing the patient complaint management process; experience with customer service, service recovery, and/or improving the patients experience and knowledge of Complaint Management systems.

Patient Access Service - Four (4) years of experience coordinating and training employees on PAS activities including: pre-authorization, insurance verification, and registration; performed various patient access operations duties to include reimbursement analyses, and hospital development (patient satisfaction, community programs, communications, and new patient initiatives).

EDUCATION Keller University- Decatur, GA, MBA - HealthCare Management - January 2012

Certification in Health Services Administration - January 2012

DeVry University- Decatur, GA- BS, Business Administration - December 2009

TECHNICAL SKILLS

DOS Window 2000/ME/XP/Vista/7 Microsoft Word Microsoft Office Lytec Medical Excel Access PowerPoint Meditech Webtool CCMS Facets Database Implementation Data Dictionary

Management & Security Information Systems Security Networking Concepts and Applications

PROFESSIONAL EXPERIENCE

CLINICAL INTAKE COORDINATOR 11/2011 - Present

XL Health/United HealthCare Atlanta, Georgia

* Initial triage of members, administrative intake of members or managing the admission/discharge information post notification working with hospitals and the clinical team

* Include intake, notification and census role

* Accepts incoming Home Health referrals

* Able to take and complete accurate intakes

* Ensures that insurance verification is completed prior to giving the referral to a clinical/care manager

* Ensures that the clinical/care manager receives the referral in a timely fashion

PRECERTIFICATION REPRESENTATIVE 03/2007-11/2011

Parallon Business Solutions Norcross, Georgia

* Transmitted data about initial dates of services for all urgent and emergency care admissions and observations within 24-48 hours to various insurance companies.

* Received pended claims reports on claims received without prior authorization to research and review eligibility and benefit coverage. Upon decisions of claim payment status generations the appropriate referral with notification and exchange of information to the service organization for proper adjudication of claim payment.

* Assisted in gathering information needed for coordinators/case managers to determine continued patient services

* Contacted providers with authorization, denial and appeals process information.

CLERK & MEDICAL RECORDS CUSTODIAN 06/1999-03/2007

DeKalb Psychiatric Associates Decatur, Georgia

* Internally serviced the patient by maintaining their charts through performing record center tasks including retrievals, incoming appointments, internal moves, permanent discharges and any special projects required

* Processed all internal moves including pulling patient charts from one location and storing it in another location, investigating all exceptions and closing all patient appointments.

* Served as Patient Relations Leader receiving, investigating, documenting and working to resolve patient complaints, including interacting with Risk Management when warranted.

* Communicated with patients regarding discontinued status.

* Assisted as needed with the monitoring patient appointments, chart audit reports, and served as backup for the Office of Clinical Affairs

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