Renee M. Barden 646-***-****
**** ****** **** ****, *********, NC 28210 email@example.com
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:
-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.
-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.
-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
-MONTEFIORE MEDICAL CENTER, YONKERS, NY 2000-2007
Billing Customer Service Representative
-1199(SEIU) NATIONAL BENEFIT FUND, NEW YORK,NY 2002-2005
WESTCHESTER COMMUNITY COLLEGE, Yonkers, NY
AAS of Paralegal Studies/ Business Administration
Furnished upon request