Customer Service Project Manager
Resume:
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S A L LY N E L S O N
678-***-**** **********@*****.***
To Whom It May Concern:
Thank you in advance for considering my application. I would truly appreciate the opportunity to
interview for a position with your organization. As you can see, from my enclosed resume, my job
experience, as well as my diverse skills, make me a strong candidate for this position.
I am detail oriented and am very determined to do my job effectively and efficiently. I work well in a
team environment but can also self direct myself to accomplish my daily tasks without supervision. I
would appreciate the opportunity to discuss my credentials with you at a mutually convenient time.
Thank you for your consideration.
Very Respectfully,
Sally Nelson
Enclosure: Resume
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S A L LY N E L S O N
678-***-**** **********@*****.***
PROFESSIONAL SUMMARY
COMMITMENT LEADERSHIP INTEGRITY
Highly educated and dedicated Healthcare Professional with extensive experience in training and medical
services. Leverages finely honed interpersonal and time management skills to successfully teach a group and
increase productivity achieving program goals and objectives. Energetic and goal oriented with a genuine passion
for the health care field and a well rounded background in supporting a progressive organization in optimizing
performance and developmental growth. Astute communicator and facilitator excel at establishing rewarding
relationships to ensure patient and employee satisfaction.
AREAS OF EXPERTISE
Strong Written and Verbal
Ability to Read and Understand
Communication and Interpersonal Problem Solver in a Professional Manner
Medical Terminology
Skills
Complies with Policy and Procedures
Relationship Builder
Performs Multiple Task
PROFESSIONAL EXPERIENCE
MCKESSON REVENUE MANAGEMENT SOLUTIONS – ATLANTA, GA 2002–
2013
EVENUE CYCLE SPECIALIST/TEAM LEAD/ PROJECT MANAGER
R
Managed and directed expanding work with existing clients, implementation of new clients, and performed quality
review and training of current and newly hired associates. Assisted management with day to day operation which
includes reviewing and creating reports to be worked by team and client distribution. Tracked and updated
employee time and attendance. Provided team with associate training and coaching to bridge gaps between
company objectives, performed applicant interviews and conducted client meetings.
Monitored import files process and reviewed transactional mapping for assigned clients
Provided customer service support to clients and upper level management by establishing and maintaining
effective working relationships
Updated and maintained clients’ internal documents, while assisting with leading team meetings
Trained and assisted with work plan execution on various client specific projects to include Medicare
Secondary, Third Party Resolution and Transformation products
Provided customer service to patients inquiring about account payment arrangements
Researched account resolution on insurance denials, credit balances and unpaid medical claims
Verified medical billing for claims to responsible parties and various insurance companies (e.g. HMO, PPO,
POS, Indemnity, Worker’s Comp., Georgia Medicaid, commercial, etc.)
Reviewed accounts prior to transferring to outside collection agencies
Received and initiates calls to and from responsible parties regarding medical services
Traveled onsite to hospital to work on special projects and train hospital staff
CHAMBERLIN EDMONDS AND ASSOCIATES – ATLANTA, GA
2000– 2002
EDICAID FOLLOW UP REPRESENTATIVE/BILLER
M
Responsible for the timely submission of technical or professional medical claims to insurance companies
including physician offices, hospitals, nursing homes, or other health care facility.
Provided account balance resolution through appropriate interaction with third party entities
Obtained reimbursement for clients by submitting claims for processing
Reviewed accounts for possible hospital write offs and/or balance adjustments
Traveled to offsite hospitals as needed to work on special projects
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NORTHSIDE HOSPITAL – ATLANTA, GA 1999 –
2000
EIMBURSEMENT SPECIALIST
R
Worked with insurance and billing companies to determine correct reimbursement.
Calculated and reconciled contractual adjustments for all HMO, PPO and contractual groups (etc. Medicare,
Medicaid, Worker’s Compensation and Champus)
Reviewed EOB, remittance advices, and payer contracts for contracted accounts to ensure that proper
contractual were applied at final bill
Monitored financial movement on patients’ accounts to ensure that the correct balances were maintained at all
times, while correcting any misapplied payments that occurred
Reviewed credit balances and investigated possible reversal of discounted amount
CAPE FEARVALLEYHOSPITAL – FAYETTEVILLE, NC
1996 – 1998
UTPATIENT ACCESS COORDINATOR/EMERGENCY ROOM DEPARTMENT REPRESENTATIVE
O
Processed paperwork on emergency room deaths and DOAs. Prepared cash shift reports, collected copayments
and processed emergency room fees and ancillary charges. Scheduled appointments for various procedures.
Registered patients for various outpatient test and procedures and admitted patients when necessary
Collected insurance deductibles and copayments
Obtained authorizations and referrals from physicians’ offices for various procedures
Obtained medical diagnosis from physicians for Medicare and Medicaid patients
Trained new hires on the registration process and office procedures
Performed other administrative duties as directed
EDUCATION
MASTERS OF BUSINESS ADMINISTRATION (MBA): HEALTH SERVICE ADMINISTRATION
StrayerUniversity – Atlanta, GA
BACHELORS OF ARTS IN BUSINESS MANAGEMENT
StrayerUniversity – Atlanta, GA
PROFESSIONAL DEVELOPMENT
Advance Certified Patient Representative – February 2009
Member of RelayHealth Employee Opinion Survey Committee 2009 2012
Certified in Medic First Aid, CPR, AED and First Aid – November 2012
Local HIPPA Compliance Liaison –January 2013
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