Customer Service Representative

Renee M. Barden 646-***-****

**** ****** **** ****, *********, NC 28210 *****.******@*****.***

SUMMARY OF QUALIFICATIONS

Background encompasses 15years experience with skills and accomplishments in the areas of Customer Service, Claims Adjudication, Healthcare Billing, Client Support and Contract Administration. A conscientious individual with strong interpersonal communications skills, both written and verbal. Cooperative team member with solid analytical problem-solving and decision making capabilities. Proficient in MS Word, Outlook, PowerPoint and Excel, IDX, NextGen, EMR, Escallate, and EHR.

PROFESSIONAL AREAS OF EXPERTISE:

Medical Administration

-Maintain thorough knowledge of HIPAA compliance regulations, billing protocols and guidelines, verifying ICD9 and CPT codes, Medicaid, Medicare and Commercial insurance requirements and grievance and appeals policies.

-Verify patient eligibility, benefits, co-payment, co-insurance and deductible responsibilities.

-Handle high volume telephone billing inquiries.

-Process patient financial transactions and run payment journal reports, reconcile all cash and credit card transactions.

-Prepare and manage reports for aged claims with balances and interact with all management levels.

-Assist with special projects to maximize patient satisfaction and staff efficiency.

-Conduct expanded review of submitted medical claims.

-Interview patients to determine financial hardship and potential Medicaid assistance.

-Verify financial documents, employment and disability requirements.

-Resolve escalated patient complaints, identified and effectively managed areas of concerns.

CUSTOMER SERVICE

-Provide expert, informed and detailed information to questions received from health care professionals and patients.

-Provide updated insurance guidelines, policies and technical support to patients.

-Maintain working knowledge of insurance products and services to project a sound professional image to patients.

-Document patient inquiries into system concisely and accurately.

-Obtain and evaluate patient information, identify issues and concerns and handle according to established protocol.

-Assists with any performance improvement activities and compare data from other sources to accommodate patient requests.

-Assist patients by drawing from a solid base of accurate organizational information and resources regarding company products, programs and services.

-Facilitate skill based coaching sessions with employees and document learning opportunities.

-Provide advocacy and representative services in grievance hearings, arbitrations and disciplinary processes.

-Facilitated Contract negotiations and administration of salary adjustments.

-Recruited, trained and supervised existing staff and new employees.

EMPLOYMENT HISTORY

-DILIGENT BILLING MANAGEMENT, CHARLOTTE, NC 2015-Present

Accounts Receivable Coordinator

-ENSEMBLE HEALTH PARTNERS, HUNTERSVILLE, NC 2014-2015

Billing Operations Specialist

-ENT & ALLERGY ASSOCIATES LLP, TARRYTOWN, NY 2009-2014

Customer Service/Billing Operations Specialist

-RAYMOUR & FLANIGAN, YONKERS, NY 2010- 2013

Customer Care Representative

-AMERIPATH LABS, INC, PORTCHESTER, NY 2008-2009

Account Receivables

-MONTEFIORE MEDICAL CENTER, YONKERS, NY 2000-2007

Billing Customer Service Representative

-1199(SEIU) NATIONAL BENEFIT FUND, NEW YORK,NY 2002-2005

Contract Administrator

EDUCATION

WESTCHESTER COMMUNITY COLLEGE, Yonkers, NY

AAS of Paralegal Studies/ Business Administration

REFERENCES

Furnished upon request

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