Customer Service Medical
Resume:
Tiffany Fisher
Houston
TX *****
*.********@*****.***
SUMMARY OF QUALIFICATIONS
• Seven-plus years of experience in an Office Environment.
• Experience with public and community outreach.
• Case Management, Patient, Customer and Vendor relations experience.
• Diplomatic, tactful, creative, discreet, flexible, resourceful, dependable, well-organized,
friendly, emotionally mature and professional.
• Capable and practiced in handling complex and multifaceted tasks.
• Insurance, Employment, wage verification experience.
• Strong Analytical and problem solving skills
• Highly skilled in Various Computer programs.
WORK EXPERIENCE
Coventry Healthcare April 2013 – March 2014
Associate Insurance Specialist
Interfaced with customers via telephone, written correspondence, fax, web, and/or
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electronic mail to respond to routine inquiries and resolve concerns.
Researched customer information by effectively using internal technical tools in response
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to inquiries
Assisted with authorizations/referral request, obtaining information that would determine
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decision by medical director, process paper claims including complex HCFA 1500 and
UB04, payments, denials, coordination of benefits, and eligibility.
Resolved escalations and complex situation, provide daily metrics
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Investigates, analyzes, and resolves outstanding issues to achieve customer satisfaction
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taking responsibility for following through and bringing issues to closure.
Completed transactions including simple adjustments. Maintain complete accurate
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documentation of all customer interactions. Responsible for processing incoming claim
batches.
Accurate with 10 key pad, typing 40 wpm, uploading and scanning documents, filing,
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laminating documents, use of Microsoft applications; Word, Excel, Spreadsheet, Outlook
Health Help Inc. April 2012- February 2013
Client Service Case Manager
• Constructed administrative intake and outbound calls to request medical records for audit
while providing quality customer service through interaction with providers,
administrative staff and others
• Retrieving medical records and delivering to appropriate providers or department
• Filing medical records
• managed individual cases for clients obtaining needed info for medical decisions
• Collected and enters confidential information ensuring the highest level of confidentiality
in all areas, maintain written documentation according to HH’s documentation process,
carried out other projects and responsibilities as assigned
• Assisted with the preservation and continuous development of accurate database, multi-
task and prioritize projects in a face-paced environment, faxed, scanned, copied
information
• Knowledge of ICD-9 and procedure codes
Helping Hands Diagnostic Clinic October 2007- February 2012
Administrative Assistant Executive
• Responsible for keeping medical office running smoothly., scheduling employees
Communicate with patients, insurance companies, family members &other providers in
related field, knowledgeable of ICD-9 codes/ procedure codes
• Basic job duties include, processing patient and insurance information, verify insurance
and submitting all authorizations in a timely manner, documenting and maintaining
accounting and banking records, processing payroll (Peoplesoft, ADP Payroll software),
performing medical transcription, establishing payment arrangements, discussing
payment options and screening for eligibility
• Obtained demographic, insurance and financial information from patient or guarantor.
• Enters information in computer system with a high degree of accuracy phoning patient
prescriptions into pharmacies, filing patients' medical records and insurance claims,
placing medical supply orders and taking inventory, scheduling appointments, answering
phones and intercom and preparing invoices.
• Open, sort and route incoming mail, prepare correspondence/reports, and prepare
outgoing mail. Review files, records, and other documents to obtain information to
respond to requests.
• Proof read reports, letters and memo for proper grammar, punctuation, spelling and
formatting using MS - Word, PowerPoint and Excel.
Interactive Response Technology January 2003-September 2007
Customer Service Rep
• Communicate with new and existing customers for Midwest Region and AT&T to set up
different service such as internet, cable and phone service, etc.
• Handle collection claims for AT&T; pursue payments on debts owed by individuals or
businesses, receive inbound calls and make outbound calls.
• Handled insurance claims.
• Answer multi line system up to 200 calls per day and also make outbound calls to
promote business opportunities to customers.
• Assist with billing inquiries and set billing accounts. Data entry, use of Microsoft
applications, excel, outlook, and word.
• Performed other clerical jobs, faxing copying, taking messages, distribution of mail,
Microsoft applications
EDUCATION
Houston Community College
Associate of Arts Degree in Human Resources
References
Simonne Cossom
Coventry Healthcare-Supervisor
Houston, Texas
********@****.***
Ashley Payne
Helping Hands Diagnostic Clinic-Office Manager
Houston, Texas
Chanequa Lewis
Helping Hands Diagnostic Clinic-Owner
Houston, Texas
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