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Customer Service Medical

Harrisburg, PA
March 07, 2018

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*** *. **** ******

Harrisburg, PA 17111

Mobile: 717-***-****



MAGELLAN HEALTH Rx December 2017 to Present, (Contract) Pharmaceutical Claims Specialist Full-time 40 hours per week

4000 Crums Mill Road, Harrisburg PA 17112

Responsibilities: PACE program (Pharmaceutical Assistance Contract for the Elderly) Handles inquiries from Pharmacies, Providers and Card Holders regarding prescription claims and the PACE program. Initiates overrides per policy guidelines as necessary. Researched drug pricing inquiries and coverage limitations. Provides program guidelines information to patients.

O’REILLY’S TAP ROOM & KITHCEN August 2017 to Present Customer Service Team Member Full-time 40 hours per week

800 E. Park Drive, Harrisburg Pa 17111

Responsibilities: Provide service to customers, presenting specials, retaining orders, and check back for customer satisfaction on order.

FAMILY MEDICAL CENTER/ GEISINGER March 2017 to August 2017 Authorization Specialist Full-time 40 hours per week

225 North Front Street, Steelton Pa 17113 717-***-****

Responsibilities: Served as a liaison between patient and medical support staff. Processed insurance referrals and authorizations. Collected all insurance data necessary from clients and determine if authorization was necessary for the recommended services. Handled scheduling procedures with insurance approval. Followed up on rejected or denied claims. Provided a variety of secretarial duties to physicians and other members of the clinical staff. Assisted patients with all inquiries regarding the services provided.

EPIC HEALTH SERVICES August 2016 to March 2017 Operations Specialist/HR Full-time 40 hours per week

1862 Charter Lane, Suite 102, Lancaster PA 17601 717-***-****

Responsibilities: Provided support to the Human Resource administration Department within the branch. Assisted with the creation and maintenance of all employee personal files. Verified employee credentials and licensure (professional staff). Responsible for the coordination of the hiring process and documentation of employee changes. Assisted new employees with benefit enrollment and utilization. Maintained confidentiality of all employee and client records and information, Ensured confidentiality is maintained for all Epic patients and employees. Participated in filing of documentation and records. Answered incoming calls for Epic. Referred telephone inquiries to the appropriate staff. Performed special projects and administrative supports duties as assigned.

HOMELAND HOSPICE May 2013 – November 2015 Administrative Assistant Full-time 40 hours per week

2300 Vartan Way Suite 115, Harrisburg, PA 17110 717-***-****

Responsibilities: Manages hospice office functions including clinical records, personnel file maintenance and data processing operations that are consistent with regulatory, compliance and agency policies, procedures and standards. Working under the direct supervision of the Assistant Director for Support Services, this position provides all necessary organizational and office support for the hospice team and office.

CHAMBERS HILL FAMILY MEDICAL CENTER August 2011 – May 2013 Medical Secretary Full-time 40 hours per week

5400 Chambers Hill Road Harrisburg, PA 17111717-***-****

Responsibilities: Performs multiple activities assisting in the over-all operations of the accounts receivable department. Responsible for reviewing and analyzing individual case information to determine the most effective course of action in a debt recovery function. Performs various accounting, budget or financial management support duties or assignments. Handles contractual adjustments to the billing file and patient account as required by the insurance contract with the insurance company. Audits all out-going invoices processed by the Billing Technician for costs and itemization accuracy. Provides counseling, answers questions and explains deductibles, co-payments, and application of insurance payments to the patient. Identifies deficient areas in the billing and accounts receivable process and works with relevant parties to resolve problems in such a manner as to advance future process efficiency.


Completed Externship - Veteran Affairs Medical Center, Lebanon PA.

Working in MCCR on AR and Insurance Claims

Follow ups - 3rd party follow ups on outstanding claims via phone calls.

Checks - apply third party payments to active claims.


Medical billing and Coding, Data Entry, Follow ups with Provider and Facilities, Customer Service, First Trax, Medent, Medisoft, Medics, Healthtrust and Kareo Billing Software, Microsoft Excel, Dual Monitors, Word, Access, PowerPoint, Internet Explorer, Staff Management, Payroll, Scheduling, Multi phone lines

Current FBI, State and Child Abuse Clearances

Current Tuberculin test / PPD

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