Customer Service Insurance
Resume:
Toni Jean
****.********@*****.***
Objective
To obtain a challenging position that will fully enhance my education, experiences,
and interpersonal skills, while allowing me to build upon my ever-growing
management experience and abilities.
Education
Masters of Public Health
Florida Agricultural & Mechanical University
August 2010 – May 2013
Bachelor of Science- HealthCare Management Degree
Florida Agricultural & Mechanical University
January 2008 - May 2010
Professional Experience
June 2006 – Present
Walgreen Pharmacy - Tallahassee, FL.
Pharmacy Technician Supervisor ( CPhT)
• Supervises day to day operations that include electronic medical records, data entry, quality
assurance, and patient satisfaction.
• Provides superior customer service to the patient and family by assisting in enrollment and
completion of required paperwork and program applications, such as for PBM, Medicaid,
Medicare and private insurance carriers
• Manages inbound calls on the Insurance line from patients and physicians, regarding inquiries
about services provided, financial responsibility and insurance coverage.
• Ensures and adheres to strict confidentiality when handling patient charts, records, and
scheduling information.
• Communicates with third-party payers to obtain authorizations/pre-certifications for patients’
scheduled prescription as needed, in addition to documenting the information in the registration
system.
• Collaborates with patients, pharmacy techs, pharmacist, and referring physician offices to ensure
that all necessary information is obtained from patients before their scheduled compound
prescription.
• Maintain confidentiality in compliance of Federal HIPAA Regulations.
• Documents all information obtained during pre-registration activities to ensure patients’ accounts
are complete for forwarding to other departments.
• Accurately and thoroughly collects, analyzes, and records demographic, insurance, financial, and
clinical data in computer system.
Facilitates and completes the Prior Authorization process with insurance companies and
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practitioner offices.
March 2012 – Present
Tallahassee Memorial Hospital - Tallahassee, FL.
Neurology Unit Secretary
• Maintain efficient telephone triage, appointment scheduling, registration, patient flow and
discharge procedures to enhance patient satisfaction and physician productivity.
• Enters patients into the patient tracking system upon arrival per department procedure.
• Interprets physician orders to determine service needs.
• Collects and scans physician orders or verifies the completion and validity of orders are on file
for each patient.
• Reviews and explains all registration forms prior to obtaining signatures from patient or
appropriate patient representative.
• Ensures patient’s identification band is securely fastened upon completion of the registration.
• Work collaboratively with all internal and external customers and departments to ensure timely
and accurate patient registration and processing related to all aspects of the patient access.
• Provides training and/or coordination of training on general office procedures, registration, and
scheduling and customer service.
• Resolves patient complaints and related issues. Serves as a liaison between patients, physicians,
and departments
February 2007 - March 2012
Disability Apex- Bond Community Health – Tallahassee
Disability Practice Administrator
• Manages the daily operations of the office functions which include staff scheduling, cash
reconciliation, charge entry, and operational checks and balances.
• Manage employees including final approval of hiring decisions, performance appraisals,
scheduling, training, employee development, disciplinary actions.
• Provide first class customer service by greeting customers as they enter the office,
keeping the office clean and inviting, and answering the phone in a courteous manner.
• Ensures execution of operational standards, including compliance with established
company policies, procedures, and government regulations.
• Develops reports on billing activities and identifies positive and negative trends for
management, and identifies and recommends potential corrective actions to address adverse
trends.
• Prepares regular periodic reports and monitors system reports to ensure adherence to
corporate and regulatory standards
• Manages internal budget, reviews expenses, purchases supplies, and inventories.
• Develop guidelines for prioritizing work activities, evaluating effectiveness and
modifying activities as necessary to ensure appropriate staffing levels are maintained.
• Makes sure facility is a safe, clean, comfortable, and appealing environment for patients,
visitors and staff in accordance with OSHA guidelines.
• Interpret financial reports/data to effectively manage the office and inform about the
business
Contact this candidate