Customer Service Representative

Jeffrey Begley

Benefit Analyst - Florida Hospital Health Systems

Clermont, FL

******@*******.*** - 407-***-****

To utilize my experience and skills in the medical profession to enhance productivity in servicing both customers

and providers.

WORK EXPERIENCE

Benefit Analyst

Florida Hospital Health Systems - Orlando, FL - November 2012 to Present

Enter claim payments, reserve new claims, input file documentation

• Resolve UB & HCFA claims

• Maintain claim files requiring detailed analysis

• Verify and analyze data used in settling claims to ensure that claims are valid and that payments are made

according to company practices and procedures

• Company Representative at annual benefit fair

• Responsible for training and auditing new hires

Patient Registration Coordinator

Quincy Medical Center - Quincy, MA - August 2010 to February 2011

Interviewing, Scheduling of appointments and Pre Registration

• Insurance Verification and Referral Outreach

Member Service Representative

Blue Cross & Blue Shield - Quincy, MA - March 2008 to May 2009

Consistently provided members with exceptional customer service

• Complied with HIPAA rules and regulations

• Investigated and resolved member inquiries through correspondence and computer research

• Identified errors and implemented solutions with team members and leaders

• Trained new employees in all operations areas

• Redeveloped existing staff through audits and reprocessing of claims

Billing Manager

Plymouth Bay Orthopedics & Physical Therapy - Duxbury, MA - June 2007 to February 2008

Responsible for Medical and Billing Records

• Assisting with obtaining provider insurance numbers and credentialing

• Overall physical therapy reception office organization and management

• Specific duties included performing medical billing and denials management, assessment of insurance

compliance and payment denials, contacting patients and other payers to ensure prompt payment for services,

assisting with provider enrollment / re-enrollment with third party payers, and educating staff intermittently to

ensure program compliance

Learning and Development Specialist

Tufts Health Plan - Norwell, MA - November 1996 to October 2005

Training of new employees in all operations areas

• Redevelopment of existing staff through audits and reprocessing of claims

• Documenting and presenting new policies to staff

• Analytical support to project managers

EDUCATION

Business Management

Quincy College - Quincy, MA

1990 to 1992

ADDITIONAL INFORMATION

Key Skills

• Medical Claims Adjudication

• Excellent Interpersonal and Phone Skills

• Corporate Trainer

• MDCR Part A, B, & D Billing Experience

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