Customer Service Representative

TINA M. CAMPBELL

Core Qualifications

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*** ***** **., *****, ** 92083 • 858-***-****• ********.*********@*****.***

Summary

Accomplished Healthcare Administration with 11 years of experience in coordinating

referrals, verifying insurance, and representing patients in hospital and clinic settings.

Cultivate strong industry relationships to drive business development and branding

i nitiates. Highly skilled in addressing patient concerns with speed, accuracy and the utmost

p rofessionalism. Wavering commitment to customer satisfaction, with the ability to build

p roduct relationships, resolve complex issues, and win customer loyalty.

Core Qualifications

• Certified in Medical Front Office procedures.

• Working knowledge of EPIC, PCIS, IDX ORSOS, Lake Revenue Protect, CPT

codes and ICD 9 Codes. Proficient in Excel, and Lotus Notes, M icrosoft Word.

• Knowledge of EMTALA and H IPPA laws, state government and thi rd party

payees, PPO, H MO, Tri-west, VA, WC, Medi-cal and Medicare, County Medical

Services.

Experience

Customer/Patient Service

• Treated all patients and their families, visitors, peers in a pleasant and

courteous manner. Maximized patient satisfaction and drove business

development by ensuring t imely and accurate registration for all new clients.

• Enhanced patient satisfaction through the prompt resolution of patients' billing

concerns, eliminating the need for escalation or recur ring patient calls.

E xcellent relationships with insurance carriers and internal teams, resulting in

t imely resolution of issues.

• Streamlined front office operations by organizing patient files, preparing all

relevant documentation in advance of need, and keeping patient informed of

changes, updates, and other factors.

I nsurance Verification/Refer ral Coordinator

• Precisely reviewed and verified patients' insurance coverage, deductibles,

possible insurance carrier payments and remaining balances not covered under

t heir policies.

• Ensured all patients scheduled for services were eligible and authorized for

t hose scheduled services and monitored restricted services payers. Advised

patients of medical financial policy and collected any deductible, co-payments

and out of pocket payments owing.

Claims Resolutions

• Appropriately and correctly identified errors and re-filed denied/rejected claims.

• Improved reimbursement through ensuring the t imely filing and submission of

claims. Instrumental in identifying denial t rends and partnering with internal

departments to address root causes, contributing to a reduction in claims

denials.

• Researched CPT and ICD-9 coding discrepancies for compliance and

reimbursement accuracy. Prepared and attached all required documentation

i ncluding referrals, t reatment plans or other required correspondence to reduce

i ncidence of denials.

Financial I ndustry

• Over 13 years working for different mortgage companies.

• Monitored Accounts payable, prepared monthly reports, performed all aspects of portfolio

administration including loan boarding, interest rate modifications, portfolio audits,

credit reporting, tax and escrow analysis.

• Supervised up to 15 office employees.

Work History

Allied Health Agency/Kaiser Permanente Outside Referrals Clerk 04/2014 - 11/2014

Sonora Region Medical Center Referral Coordinator 11/2013 - 02/2014

UCSD Medical Center Insurance Verification Specialist 03/2012 - 11/2013

Scripps Clinic Business Service Representative 07/2007 - 10/2009

Pomerado Hospital Patient Service Representative – ER 08/2006 - 08/2007

Fallbrook Hospital Financial Counselor 03/2003 - 03/2006

Chase Manhattan Mortgage Customer Care Representative/Call Center 03/2002 - 03/2003

Old Kent Financial Sr. Customer Service Representative 02/2000 - 03/2001

Green Point Credit/BOA Sr. Operations Manager 09/1989 - 02/2000

E ducation

Coursework In Medical Billing and 2003 Career Tech Vocational

Coding/Front Office Assistance College, Temecula, CA

References

References are available on request.

Contact this candidate