Customer Service Representative
Resume:
Nida Vorasarn
Des Moines, IA *****
*********@*****.***
September 2012 – December 1, 2017 Orthopaedics of West FL Largo, FL
Team Lead
Managing front desk employees
Balanced daily collections
Checked in and checked out patients
Verified Insurance/ Authorizations/ Scheduling
Resolved patient billing and insurance issues
Maintained records and accounts
July 2009- September 2012 Universal Healthcare St. Petersburg, FL
Appeal Analyst
Handle disputes claim denial
Responsible for the research and completion of standard appeals within the company
Address all concerns and ensure timely, complete resolution and satisfaction
Ensure timeliness, quality and efficiency in all work to comply with applicable mandated state and/or Federal legislative or regulatory requirements
Work up cases for Medical Director to review to mainly resolve claim disputes
Consult and confer with Medical Director and other clinical staff to ensure the appropriate decision has been made and the approved outcomes are implemented
Conduct a thorough investigation and often must contact more than one party to resolve the dispute
Review an applicant’s contract, summary of benefits, claims history, enrollment status and sometimes medical records to make an informed decision
Response letters to applicants include claim information and cite specific parts of a contract to uphold or overturn denial
Prepared cases for ALJ Hearing or Medicaid Fair Hearing for Medical Director
February 1998 – July 2009 All Florida Orthopaedic Associates St. Petersburg, FL
Scheduling Manager/Front Desk
Managing scheduling department and front desk employees
Responsible for the Physicians and Therapy scheduling templates
Maintain the schedules of the employees in the department to ensure the hours are correct on a weekly basis
Make sure all positions have proper coverage
Balanced daily collections
Checked in and checked out patients
Verified Insurance/ Authorizations/ Scheduling
Resolved patient billing and insurance issues
November 1995 – January 1998 Medical Developmental Research, Inc Clearwater, FL
Customer Service Representative
Take telephone orders
New order data entry
Invoicing and auditing of accounts
Responsible for all purchasing for the department
Accounts payable
November 1994 – August 1995 Ethan Allan, Inc Providence, RI
Customer Service Representative
Take telephone catalog orders
New order data entry
Balancing of daily posting ledger
Accounts receivable posting
Various secretarial duties
Skills – Type 80 wpm, 10,000 kph, various PC programs, MSOffice, Word Perfect, Medical Manager, M*A*S 90, Reflex, NextGen Software and Athena Net.
Education
Hoover High School – Diploma
Kelsey Jenney Business College – Associate of Arts
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