Customer Service Insurance

Objective

To be gainfully employed with an organization that will allow me to

express myself through my talents and education. To have a long and

beneficial career within. Also it will grant me the opportunity to

grow within the organization, working my way into becoming an asset

to the company and inspiring others through the opportunities that

was provided to me.

Work experience

June 2014- Current

Neurology and Sleep Specialist

Front Desk Admin/Insurance verifications

Greet and check in Parents and Parents

Answer any questions about visit or testing parents may have.

Allocate all co-pay received and ensure proper claim payment has been

rec'd from carrier and patient.

Verify insurance coverage and determine patient benefits for all office

providers.

Determine which appointments will require a referral from the patient's

primary care physician.

Answer patient questions regarding the benefits and requirements of their

plan for specialist office visits.

Provide patients with a courtesy call, at least one day prior to their

scheduled appointment, to make them aware when the amount due at the time

of service will be over $100.

Collect co-pay or deductible at check in and offer a receipt.

March 2014-June 2014

A.D Susman Staffing- Work Site: Texas Children's Hospital

Welcome Desk- Ambulatory Service

Perform patient registration procedures

Refer patients with inadequate funding to the financial counselor

Ensure patient forms are provided and filled out for the visit

Assist licensed staff with non-financial aspects of the inpatient

admission process

Advise of insurance responsibilities

Schedule for open slots schedule patients

March 2012-December 2013

Apria Healthcare DME

Intake Specialist

Verifying patients' insurance coverage

Answering patients questions

Processing incoming prescriptions for DME

Key new supply orders for CPAP an Oxygen

Process hospital discharge oxygen orders

In charge of orders from VIP doctors

Meet productivity criteria

Follow-up on pending referrals

July-2011 to March 2012

Department of Veteran Affairs

Site worked: Florida Caribbean Patient Account Center

Orlando, Fl

Submit properly executed medical claims on a timely basis to third party

payers and responsible parties.

Maintains strictest confidentiality; adheres to all HIPAA

guidelines/regulations.

Initiates third party reimbursable encounters and insurance claims for

healthcare services provided to the patient.

Verify that all CPT codes are billable to patient's policy.

Ensuring that all professional and facility services are identified and

generated on each bill.

Verify that patient's insurance policy is active for date of service.

Jan-2010- July2011

Orlando, FL

Advance Care Scripts

Reimbursement Specialist

Insurance verification i.e.

BSBS,Aetna,CHAMPVA,Tri-Care,UHC,Medicare,Medicaid

Enroll patients in Co-Pay assistance program

Assist patients with specialty pharmacy mail order delivery.

Verify copay, deductable, benefits max with patient's insurance company.

Verify and explain patients Medicare part D plan

Obtain per certification for medication and procedure

HIPAA guidelines

April-2005- December-2009

Orlando, FL

Rotech HealthCare

A/R Collection Specialist

Processes rejections and denials to determine appropriate action in

regards to A/R follow up.

Process all Payer appeal requests within the time frame required by the

Payer

Verify patients insurance

Processes doctor and insurance changes.

Analyzing A/R data and prepared for recurring reports for submission to

management.

Process Finical assistant applications

Respond to written and electronic inquiries regarding patient accounts,

eligibility issues.

Accounts Receivable

Documents work performed/action taken on AR Aging Report

Verifies all batch information for accuracy.

Posts patient line item.

Processes patient payments and refunds.

Electronic & Paper Claim Submissions

Reviews non-EMC claims, reviews invoice billing,

Sort claims by Primary and Secondary

Keys and submits some EMC claims to specific payers.

Provided clerical support to A/R collectors

SCHOOL

1999-2003 Jones High School High school Diploma Orlando, Fl

SUMMRY OF QUALIFCATIONS

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Experience in Emergency/Hospital setting

Exceptional Customer Service Skills

Ten Key Expert

Microsoft applications including but not limited to Word and Excel

Excellent communication skills

Exceptional in Internet navigation and research

Working knowledge of EmDeon, Cortex, IMBS, AHCA Florida Medicaid wed

portal, GHP Georgia Medicaid web portal

Contact this candidate