Customer Service Representative

Location:

Salary:

Posted:

January 10, 2019

MELISSA A. GONZALEZ

Grand Prairie, TX 75050

Email: *******@***.***

Seeking a responsible position allowing me to utilize my acquired skills to become an asset of a growing and stable company.

SUMMARY OF QUALIFICATIONS

More than 27 years of Customer Service experience

Proficient knowledge of Microsoft Office applications

Extensive knowledge of revenue codes, medical terminology, CPT and ICD-9 codes and Provider billing practices

Strong analytical skills, creative problem solving abilities and multi-tasking capabilities

Knowledgeable of Aetna Products such as Managed Care, Aexcel, Aetna Healthfund, Traditional and Open Choice Plans

Organization and time management skills

Adaptable to new situations and changing priorities

Bilingual

PROFESSIONAL EXPERIENCE

AETNA ARLINGTON, TX

Customer Service Representative 02/15/99 to 08/26/17

Healthcare Concierge 08/27/2012 to present

Answers questions and resolves issues as a “single-point-of-contact” via phone calls, letters and internet requests from members/associates

Provide claim status information, benefit coverage interpretations and plan eligibility

Educate customers on benefit plan information and self-help services such as the Physician Web-site and Aetna Voice Advantage (AVA)

Handle escalated and/or supervisory calls

Abraham F. Syrquin, M.D. Grand Prairie, TX

North Carrier Surgicenter

Office Manager 12/16/86 to 02/12/99

Manage medical office and Ambulatory Surgical Center

Responsible for overall operations and supervision of Billing/Collections

Responsible for assuring compliance with policies and procedures for Credentialing,

OSHA, Medicare for ASC.

Develop and implement collection program for surgeries to maximize revenue

Assist patients with understanding their insurance plan

Post payments and enter medical and surgical charges

Insurance Verification. Claims filing and collecting, posting payments, daily deposits

EDUCATION

Grand Prairie High School Grand Prairie, TX 05/1987

High School Diploma

REFERENCES UPON REQUEST