Customer Service Medical

Sophia Hansen

***-** ****** ****, *** Gardens NY, 11415/ Phone-718-***-****

*************@*****.***

O bjective and Goals:

Working with some of the most outstanding Hospitals in the country, makes you understand healthcare in a whole

new way, expanding your goals to achieve the highest level of customer service in the industry, working with people

who make decisions on a daily basis that impacts everyone with the quality of care a patient receives. Being a Medical

biller/Finance Assoc. /Manager over the years I have grown to master the importance of meeting the needs of the

hospital I represent and the people who depend on me. Applying what I have learned to ensure company expansion

by improving financial goals.

E xperience is as follows:

C ompany Confidential July 2013- Present Finance Associate

Heavy follow up on outstanding claims, Contacting insurance companies for claim review, reprocessing and

appealing, requesting reconsiderations and obtaining retro authorizations for both Inpatient and Outpatient in a

hospital setting. Contacting patients for balance billing on Patient Eligibility and responsibility on claims that have

been processed with patient responsibility (Deductibles-Co-insurance and Non-covered services), checking Epaces for

Medicaid eligibility and online for manage care eligibility, No- Fault and Workers Compensation. Making sure all

claims have less than 30 day lags between follow up, Reporting to supervisor with progress on a daily basis.

1. Follow up

2. Detailed Oriented

3. Knowledge of billing procedures and HIPPA guidelines

4. Due Diligence

Westchester Medical Center July 2011- Feb-2013/Team Leader of Charge Entry for Cardiology and

Vascular Division

Team Leader of the charge entry department for the Cardio/Vascular division, making sure every bill gets out to the

clearing house through the IDX system and E-commerce, looking over Edits, addressing provider billing errors, staff

oversight and HIPPA billing guidelines. Achieving financial goals at month end meetings, providing insight on how to

improve the quality of productivity for the company and hospital while considering the needs of staff to ensure a

stress free work environment.

1. Strong Data entry

2. 24 hr turnaround time.

3. Team Lead 3 other people.

4. Strong Attention to detail.

N YU Medical Center March 07-July 09/Senior Financial Assoc.

Applying contractual rates to outstanding claims for a zero balance, posting checks to open accounts, compiling data

for Excel spread sheets for manager review, making insurance calls to verify that payments has been made or

-pending. Refunding checks to carriers who have paid above the contractual rates and is requesting take backs.

Accessing medical records for International accounts making sure that claims are paid on time according to

contracts. Ensuring payment arrangements are made and followed up on in a timely manner. Overseeing the

Catastrophic fund for patients who are seeking Medical attention from NYU due to lack of Medical facilities in their

own country. Self-pay patients looking for Cosmetic care, and in need of payment plans to meet their needs.

1. Strong multi-tasking skills.

2. Ability to work under pressure.

3. High volume of accounts with AR follow up and resolving skills.

4. Ability to work independently.

North Shore LIJ Health System July 05-March 07/ Financial Assoc. /Biller

Taking patients calls, addressing all concerns from the quality of care to the outstanding bills they receive either by

their carrier or by the hospital/provider. Applying a heavy volume of EOB's to accounts adjusting to patient’s

responsibility or denial and submitting to secondary carrier. Making payment arrangements when necessary.

Obtaining Medical records to appeal Insurance decisions, working closely with colleagues for consistent work flow

and keeping productivity high.

1. H eavy call volume 70-80 calls a day

2. Multi-tasking EOB’s and patients calls

3. Strong communication Skills

4. People friendly and account resolution

E ducation

GED

Associate in Medical Administration / Monroe College/Continuing.

Certificate in Medical Coding and Terminology C.B.C.S

Proficiency Skilled in:

IDX-GE Centricity Medical Manager Patient Keeper Epass Eagle

HTS E-Commerce (clearing house) Laser Fiche Keane Optimum

Microsoft Word/Excel Invision AEOS/Huron Epaces Internet Navigation

Medical Terminology/ICD-9 Strong Communication Skills Strong Inter-Personal Skills

Strong Multi-Tasking Skills.

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