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Customer Service Representative

Location:
Everett, Washington, United States
Salary:
Open
Posted:
October 31, 2018

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Resume:

Nicole Gregersen

Patient Services

Everett, WA **201

ac7kk3@r.postjobfree.com

425-***-****

Excellent communicator with experience working in a demanding call center environment as a customer service representative. Recently in the medical insurance field. Processing of medical insurance claims. I have a strong passion for helping people and resolving issues that may arise. Core Strengths

• Conflict resolution

• Creative problem solver

• Listening skills

• Excellent communication skills

• Internet research

• Telephone inquiries

• Customer service

• Telecommunication skills

• Multi-line phone usage

• Ten key

Authorized to work in the US for any employer

Work Experience

Medical Records Coordinator

Ciox Health (Providence Health and Services) - Everett, WA April 2017 to Present

I currently process all medical records requests for Providence Health and services for lawyers, Doctors, Patients, Insurance, VA, DSHS, etc. by strictly following the Hipaa guidelines. I also take all calls on status and advise why requests have been denied and what would be needed to complete requests. Customer Service

UMR- UNITED HEALTH GROUP

August 2013 to April 2017

Responsible for taking inbound customer service calls. Assisting members and providers with benefit quotes and reprocessing claims. Responsible for keeping all stats at production standards. Assisting members to educate them to understand their benefits and communicate with their providers about the insurance side of their services. Processing medical insurance claims according to policy and plan specifications. Collector

Biller - Everett, WA

February 2013 to June 2013

Responsible for billing durable medical equipment, billing claims to DSHS and OMAP and multiple other insurance plans, according to the guidelines of that plan. Problem solving issues with patients accounts including documentation to obtain authorizations. Working with multiple applications including Microsoft office, Provider one, and Brightree

Collector

Biller - Everett, WA

February 2012 to February 2013

Responsible for billing durable medical equipment, billing claims to DSHS and OMAP according to the guidelines of that plan. Problem solving issues with patients accounts including documentation to obtain authorizations. Working with multiple applications including Microsoft office, Provider one, and Brightree. Customer Service Representative

Essence Healthcare - Lynnwood, WA

November 2009 to December 2010

Responsible for taking inbound customer service calls while logging them into our data base. Responsible for processing general correspondence and entering all HIPPA authorizations for members, including, also processing of claims and contacting providers for members. This also included taking provider calls requesting insurance benefit quotes.

Customer Service Representative

Correspondence and Appeals - Burlington, WA

February 2005 to September 2009

Started out with this company as a customer service representative where I took incoming calls and input the call into their database while talking to the member on the phone and also taking provider calls and giving them insurance benefit quotes and adjustments on claims. After 1 year in Customer Service I was given a promotion to the Correspondence and Appeals department processing general correspondence then was given the specialty of DME

(Durable Medical Equipment) processing all requests for preauthorization and appeals and followed up by drafting and sending out letters with the determinations until we then decided to take all specialties and then I was processing all preauthorization and appeal requests which included DME, transplants, dental, investigational, cosmetic, etc., and sending out correspondence with the determinations by drafting letters and including all policies with the letters along with being a backup to the phone representatives when needed. Education

Vineyard High School - Livermore, CA

1990 to 1994

working towards Bachelors in Business with focus on Healthcare administration in Bachelors in Business with focus on Healthcare administration Strayer University-Maryland

January 2017

Skills

10 Key, experiance with a large number of scheduling billing and data entry programs in the Medical insurance and billing system (10+ years)

Groups

Concierge Team Member

February 2015 to April 2017

I am currently on the concierge team at my current employer and we handle our most important clients and we have been cross trained in all benefits from Medical dental vision flexible spendfing and even do intakes for our preauthorizaion nurses



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