Customer Service Information
Resume:
Kristi Cousins
**** *********** ***** ***. **
Mobile, AL 36606
***************@*****.***
Summary
Dedicated and focused individual who excels at prioritizing completing multiple tasks simultaneously
and following through to achieve project goals. Seeking a role of increased responsibility and authority.
Work Experience
Alorica
Patient Access Representative October 2016 –Present
Responsible for ensuring the delivery of outstanding customer service in the performance of assigned duties including scheduling patient clinical services and necessary pre-registration requirements which may include obtaining complete and accurate patient demographics, benefits eligibility, pre-certification approvals from insurance companies and physicians offices, identifying insurance and/or patient responsibility, collecting identified co-pay/deductible and/or providing financial counseling when appropriate. Maintain a professional relationship with the patient while providing excellent customer service and performing assigned duties. Document pertinent patient information and all account work activity in the appropriate systems dictated by the health care facility and Company. Responsible for capturing and documenting all pertinent patient demographic, subscriber, and insurance information (i.e.): patient Policy and ID numbers, subscriber, guarantor, payer address, phone numbers, and other contact information. Documentation must include, benefit effective date, copay, deductible, out of pocket non-covered services responsibilities, co-insurance, stop loss amounts, percentage of coverage and any other pertinent information concerning the specific procedure/clinical service to be performed. Responsible for securing authorizations and documenting all pertinent information (i.e.): Insurance, Ordering information, Physician information, Tax ID, CPT, HCPCS and ICD 10 codes. Documentation must include, authorization status, authorization number, ordering procedures, verified from, dates approved for and any other pertinent information. Responsible for meeting all patient registration goals in a timely manner to ensure time sensitive requirements are obtained. Working knowledge of Protected Health Information (PHI), HIPPA. Personally responsible, respect for self and others, innovative through teamwork, dedication to caring and excellence in customer service. Obtains complete and accurate insurance information and completes insurance verification by contacting patients, physician offices and insurance/payer regarding the visit. Works according to standard operating procedure during ADT/system downtimes. Reviews work and ensures accuracy, particularly patient type, code identification, insurance and demographic information to minimize error rate and time delays in clinical and billing departments. Responsible for assessing financial responsibility, resources, and/or referring patients for financial counseling, if necessary, based on the individual’s financial condition according to charity policy. Responsible for communicating with patients regarding patient financial responsibilities before or at time of service. Informs patients on billing process for facility and providers. Responsible for understanding and complying with all policies, procedures, and regulations relating to job duties. Perform other duties as assigned by management.
Clark Personnel – American Equity Underwriters
Underwriter Assistant July 2016-Oct 2016
Assist the underwriter in gathering and compiling required information to properly underwrite and price
risks submitted for consideration. Receives applications for workers’ compensation insurance received via email, fax, web-site and in person from customers including contracted insurance agents. Obtain
information for application; enters application information into policy administration system and forwards to appropriate staff for disposition.Processes requests for renewal policies and enters adjustments to basic policy information, payroll, and premiums based on assigned authority level.
Processes routine to complex NCCI information and forms.Responds to inquiries from employers,
employees and insurance agents concerning workers’ compensation policies, procedures, and rules.
Clerical duties such as making policy packets, processing reports, scanning and indexing, daily system
generated reports and mail-out for policyholders and agents. Other duties as assigned.
Specialty Aviation Underwriters-
Underwriter Analyst May - August 2015
Analyze applications and screened applicants, created applications for quotes from Aviation agents. Prepared quotes and renewals for Underwriters, and track them throughout the underwriting process; by pulling and files for renewal month. Communicated with agents, our internal staff, and answering routine
questions to remove binding policy towards completion. Created generic customer fulfillment materials
from document template. Maintained insureds file, tracking systems and internal reports. Issued policy
binders/renewals and crafted mid-term endorsements followed-up on pending issues by speaking with
Aviation Agents via email or phone. Issued cancellations on policies due to non payment or applications not received. Responsible for all general clerical duties to maintain the office.
North America Onsite- Mercedes Benz US International
Assembly Team Member March 2012- May 2013
Work on assembly line for Mercedes-Benz. Built cars, adjusting sunroofs,
Adding seat belts, drain hoses, expansion boxes, brake lines, washer bottles, A/C lines, degas hoses, coolant hoses, fluids in vehicle. Prep glass for rear window and lift gate glass. Install wheel house covers.
The Outsource Group
Insurance Claims Representative January 2012- March 2012
Validated the information on all medical claims from medical facility or patients seeking payment from
their insurance company for denied or rejected claims. Thoroughly review each claim to ensure that there was no missing or incomplete information. In addition, kept meticulous records of claims and followed upon lapsed cases. Extensive knowledge of medical terminology and compute experience. Handled VA
claims and spoke to VA representatives each day to assist why claims were denied or rejected.
T-Mobile USA
Customer Service Rep Nov. 2009- April 2011
Assisting customers with current rate plans, new services, changes in existing service, adding lines to current plans and purchasing accessories.
Assisting with resolving issues with customer handsets, and taking bill payments, as well as upgrading their current phone to a newer one. For new customers, run credit checks to qualify them for specific rate plans according to their need. Utilize the following systems on a day-to-day basis; Quik View, CAM, POS, and Watson. Open/close store, according to policy and procedures. Handled a substantial amount of cash, credit card, and check transactions on a daily basis.
Blue Cross/Blue Shield of AL Birmingham, AL
Customer Service for Claims Oct. 2008- Feb 2009
Responds to inbound customer calls in a professional manner and addresses customer issues while assuring that company standards are met. Researches and resolves a wide variety of customer questions and issues. Ensures information communicated to the customer is timely and accurate using proper grammar and articulation. Utilizes multiple systems to research necessary information to resolve the customer's questions or issues for ex: claims, providers, benefits, effective dates, updates, and other insurances verified. Responds to an average of 80 to 100 calls per day in an inbound call center environment. Accurately and promptly documents all calls in system.
Education
2012 Alabama CPAR Recipient (Certified Patient Account Rep)
Kee Business College Newport News, Virginia
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