Customer Service Quality Assurance

L inda K Pope

**** ******** ****** *.*, Atlanta, GA 30316 (Cell) 404-***-****

(Email)**********@**********.***

OBJECTIVE: I am currently seeking to obtain a challenging position within a rewarding

corporation which offers advancement opportunities, work-life balance as well as provides a

positive environment where I will be able to utilize my exceptional interpersonal, customer

service and advanced computer skills. Strong Work Ethic: Reliable: Organized: Detailed

O riented

PROFESSIONAL EXPERIENCE:

Credentialing Verification Specialist (Contract Assignments)

Blackstone Professional Resources, Norcross, GA-08/12-04/13

P rograms/Software Used: PeopleSoft 8.9, In ternet, MS Word, Netsuite, Healthpak

Performed accurate verification of practitioner files for initial appointment and

credentialing

Reviewed applications to ensure information provided from physicians were valid and

complete

Maintained required record-keeping and important documents

Quality Assurance Specialist

Under direct supervision checked demographic and insurance information for pre-

registration/registration on all patients

Collected and followed up on all accounts assigned prior to, during or after admission and

d ischarge

Communicated financial policies to all patients who required early financial counseling

i ntervention

Provided information regarding resources for patients who needed financial help

Verified researched and completed all paperwork and forms to bill all types of claims for

reimbursement

Serves as patient advocate during the cycle of the account and performs initial insurance

notification of urgent/emergency hospital admissions via fax, web, and telephone

Recorded authorization information in hospital billing system and handled various other

responsibilities as assigned to support the function of the U tilization Review Department

Patient Financial Service Specialist

Children’s Healthcare of Atlanta, Atlanta, GA-04/07-01/12

Programs/Software Used: SMS, Epic, IDX, Cash Management, Internet, Email, Excel

Collected daily cash from SunTrust bank web browser and input the checks into cash

management

Recorded and posted data in excel spreadsheets

Contacted Insurance Companies regarding claim payment denials

Researched and corrected insurance claims

Answered calls regarding customer payment issues and inquir ies about denial claims

Balanced and reconciled cash as well as prepared and posted payments from lockbox

Call Center Analyst ( Patient Access)

DeKalb Medical Center, Decatur, GA-12/99-12/01

P rograms/Software Used: SMS, MS Word, Email, ISUITE

Prioritized patient f low according to acuity and scheduled patient procedures

Maintained excellent customer relations with all patients, family members, hospital staff,

physicians, billing agencies and insurance companies by handling any adverse issues

Answered and handled all routed patient information and financial services department

calls

Verified and researched patient insurance information for eligibility and updated all

i nformation in the database

Linda K Pope

2844 Reveille Circle S.E, Atlanta, GA 30316 (Cell) 404-***-****

(Email)**********@**********.***

File Clerk I & I I

Grady Health Systems, Atlanta, GA-11/97-10/99

Programs/Software Used: SMS, IDX, MS Office

Checked patients in and out of the physician’s office during office visits

Verified and filed all patient insurance and personal information in assigned charts

Provided excellent customer service to patients by assisting with any immediate needs and

following up after appointments

Posted payments and denials to the system that were received from various insurance

companies

Attended onsite classes in order to acquire extensive knowledge of medical terminology

Assisted doctor with patients in exam rooms

Office Manager

Pearle Vision Center, Atlanta, GA-05/95-11/97

Programs/Software Used: MS Office Suite

Composed, formatted, and typed correspondence letters

Prepared and managed daily project database reports and spreadsheets

Worked closely with optometrists during customer eye appointments daily

Assisted sales representatives on new products for contact lens

Answered incoming calls from customers regarding any problems or questions

Office Manager

For Eyes Optical, Atlanta, GA-10/92-04/95

Programs/Software Used: MS Office Suite, 10 Key Calculator

Scheduled appointments and followed up with customers regarding prior appointments to

handle any issues or concerns with Contact Lens or Eye Glass purchases

Performed pre-examinations on customers and eye measurements so correct prescriptions

could be entered in the system

Assisted optometrists with eye exams

Worked closely with sales representatives on new contact lens products

Verified optical insurance and completed claims

Handled customer complaints and resolved any issues

EDUCATION:

Georgia Piedmont Technical College, Clarkston, Georgia; Electrical Engineering/ Computer

P rogrammer (Currently Enrolled)

ASSOCIATIONS:

B usiness Women of America, No Labels Commit tee Member, Notary Association. I Will

Survive Inc.

Professional References Available Upon Request

Contact this candidate