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Customer Service Medical

Charlotte, North Carolina, United States
January 28, 2018

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**** ***** ****** **, *********, NC 28262 / P hone: 678-***-**** / E -mail: PROFESSIONAL PROFILE

Customer-service oriented professional with cross-functional healthcare experience and strong understanding of importance of accurate claims processing. Maintains attention to detail needed to review and correct errors and retain high levels of accuracy. Balances team and individual responsibilities.

Academic Honors Recognition / Honor Roll.

Earned “Outstanding Leadership Award” as member of The Head Start Policy Council/Personnel Committee. CORE QUALIFICATIONS

Medical Billing/Coding ICD-9-CM HCPCS CPT ICD-10 CM Medical Terminology Superbill Deductibles Electronic Health Records (EHR) Electronic Medical Records (EMR) Greenway HIPAA Compliance Tricare Centers for Medicare and Medicaid CMS 1500 CMS 1450 (UB-04) EOBs Payment Posting Revenue Cycle Management Scheduling Insurance Verification Insurance Billing Procedures Insurance Claim Processing Reimbursement Methodologies Fee Schedules Outpatient / Physician Inpatient / Facility Co-Payments Managed Care (HMO, PPO, and POS) Government Payers Third-Party Payers Worker’s Compensation Practice Management Medical Office Procedures Anatomy & Physiology EDUCATION

Ultimate Medical Academy

Associate of Science Degree – Medical Billing and Coding, 2016 Medical Billing and Coding Diploma, 2015

Certificates of Completion: CMS 1500; Medicare Fraud and Abuse Prevention, Detection and Reporting; World of Medicare and Uniform Billing (UB)-4


WestMed– Charlotte,NC 02/2016-08/2016

Healthcare Contact Center Associate

Triage incoming calls, assist clients with inquiries and various other concerns.

Prepare prescription refills access medical records, track blood work, labs, and physical results.

Scheduled MD appointments, performed doctor paging, relay on- call and emergency information.

Worked with several specialties while assisting MD's such as; OB-Gyn, Neurology, Endocrinology, Infectious Disease, Gynecology, Pediatrics, Cardio/Vascular, Bariatrics, Radiology, Pediatric Cardiology, Orthopedic, Gastroenterology Inovalon – Ann Arbor, MI 11/2015 – 03/2016

Field-Based Chart Collector

Efficiently conducted medical insurance research EMR performed audit/reviews and abstraction services.

Scanned relevant components of patients demographics in EMR to support documents needed ; then proceed to upload to home office on daily-assignments.

Completion of Medicare Fraud and Abuse Prevention, Detection and Reporting Alongside with HIPAA Compliance testing.

Conduent- Charlotte,NC


Account Solutions- Retention Specialist

Assist customers daily while providing the ultimate customer service experience. We help them find solutions to budgets and sales through Sprint. Counteract deactivations and able to retain them as loyal clients. My Brother’s Keeper Home Health Care – Charlotte, NC Nurse-Aide

Offered prompt patient care, including answering client call signals, cleaning rooms and changing linens.

Accurately prepared, served and collected food trays, while assisting clients with bathing and hygiene needs.

Maintained accurate/detailed records of all patient care efforts, including condition, progress and issues to report. ADDITIONAL WORK EXPERIENCE / VOLUNTEER HISTORY

Student Name, (Cont.)

Salvation Army Women Shelter – Charlotte, NC

Counselor / Volunteer 04/2008 – 05/2009

Assisted with the pre screening and intake of clients, while providing overview of services.

Handled individualized counseling with clients, always providing encouragement for women and children. Tryon Hills Development – Charlotte, NC

Maintenance Staff 12/2006 – 02/2008

Stripped, waxed, and buffed floors, while cleaning and sanitizing all appliances.

Seamlessly transitioned between tasks/requests within fast-paced and changing environments. McDonald’s – Charlotte, NC

Shift Manager 08/2005 – 05/2006

Directed, supervised and coordinated actions for all employees, while ensuring company store goals, cost, and customer quality services were enforced.

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