Customer Service Representative
Resume:
************@*****.***
Las Vegas, NV 89129
Experienced Certified Billing and Coding Specialist with the proven ability
to thrive in a multifunctional capacity. Eight combined years of experience
in the medical field has provided me knowledge in various healthcare
information systems, healthcare laws including: HIPAA, MEDICARE, MEDICAID,
and OSHA, as well as the ability to provide exceptional customer service.
EDUCATION
Certificate- Medical Billing and Coding
Kaplan College
February, 2014
High School Diploma
Cheyenne High School June,
2005
PROFESSIONAL PROFILE
Patient Collector
02/2014-Present
Pulmonary Associates
Las Vegas, NV
. Process new and existing patients insurance information into the
automated healthcare system to ensure accuracy and availability of the
data for future use
. Contact insurance companies via telephone and/or in writing to check
the status of new and existing claims as well as to verify new patient
information
. Compile and submit patient information to insurance companies for
payment to include information on prescriptions, sleep study details,
chart notes, compliance results, and any test results
. Bill insurance companies for services/equipment provided using HCFA
1500 Claim Forms
. Secure payment for the provider by processing appeals for denied
insurance claims in order to prevent bill excess being passed to the
patient
. Conduct in-person and/or telephonic consultations with patients
regarding their bills to include helping them understand balances,
deductibles, coinsurance, and out-of-pocket expenses as well as
collect payment for these amounts
. Educate the patient on their insurance coverage and Explanation of
Benefits and clarify any ambiguities
. Establish payment plans for the patients with delinquent accounts that
suit their financial abilities and needs as well as those of the
provider
. Manage patient payment plans by ensuring the appropriate amount is
charged against banking and/or credit card information supplied per
the agreed upon arrangement
. Maintain contact with patients to ensure they are going to send in
payment or that credit card or banking information on file has not
changed
. Analyze delinquent accounts and, at my own discretion, negotiate with
patients to return the equipment and write off the balance or give
them a discount when applicable
Neveah Rogers Page 2
Customer Service Representative
11/2006-12/2012
Medco Health Solutions
Las Vegas, NV
. Gather relevant information from members to assist them with getting
the maximum benefits from their prescription drug plan
. Verify insurance information to ensure accurate processing and
payment, including accepting co-payments and deductibles from members
. Assist members with determining and locating in-network retail
pharmacies so as to minimize their out-of-pocket costs
. Ensure member confidentiality by actively interpreting and applying
HIPAA regulations
. Effectively communicate prescription plan coverage and limitations to
members, and offer suggestions if or when needed
. Work closely with members during open enrollment to gather information
regarding prescription drug use and frequency to aid them in choosing
a prescription drug plan that aligns with their budget and medical
needs
. Use the automated Healthcare Information System, ESD, to refill member
orders and check the status of pending orders
. Inform members of medication prices and changes and changes in
coverage
. Refer members to outside resources, including Medicare, Medicaid, and
customer service for individual insurance plans, that may be able to
resolve any discrepancies that were not within my scope and range
Teller
12/2005-05/2006
Westar Credit Union
Las Vegas, NV
. Greet members and assist them in processing routine banking
transactions to include, withdrawing and depositing funds, checking
available balances, and completing transfers
. Provide members with information regarding account fees, changes, and
features
. Assist members with providing direct deposit information for their
employers
. Verify member identity prior to completing a transaction per Weststar
processes and procedures
. Maintain an average daily balance of $1,000.00 on the cash register
per Westar rules and regulations
. Deposit and withdraw funds from bank vault in order to maintain
compliance with drawer limits
TECHNOLOGY
ESD Optum Bright
Tree Microsoft Excel Microsoft Word
Microsoft Powerpoint
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