customer service rep
Resume:
DEBBIE LYNN WILLIAMS
INDIANAPOLIS, IN 46254
317-***-**** Cell
317-***-**** Message
********@*****.***
OBJECTIVE
To obtain a Full-time position within a growing company with opportunity to
utilize my knowledge and skills to advance within the company.
PROFESSIONAL SKILLS
Microsoft Word/Excel, Office Procedures, Windows 98-2000 Basic Internet
Skills, PeopleSoft/Lotus Notes/ Telephones Skills/ Turbo Cap/ SharePoint/
Anthem RX/ WordPerfect 5.1/6.10/ IDX-scheduling / Typing (30
wpm).Collections/Billing, Payment Posting, Data Entry/Filing, Editing/CPT
Coding, Phlebotomy/ICD-9 Coding/Pharmacology, Medical Terminology, Anatomy
and Physiology. TPX, X-Claims, Sovera, Centricity, Cerner, Papers,
Availity, Claim Source, Client Letter, 360 data base, FISS System,Medicaid
interchange, ICES, FACTS systems. Varies Insurance provider websites.
EMPLOYMENT SKILLS
Ability to work within fast paced atmosphere. Established excellent
customer relations with ability to follow instructions, make decisions
without supervision working within deadlines.
Skilled in Customer Service and Telephone Skills, handles customer
inquiries in timely manner.
Knowledge of working Commercial and Government Insurance Follow up and
Appeals and Denials with reference to Ambulatory Surgery Centers, Inpatient
and Outpatient services.
EMPLOYMENT
Medical Biller, Healthcare Support (Temporary)
Responsible for billing of outpatient and inpatient claims for hospital.
Reviewed edits and resubmitted claims, also followed up on past due
accounts for review of past timely filing appealing denials when necessary.
04/09/15-04/22/15
Customer Service Representative,Stericycle
Responsible for receiving inbound calls from clients to assist with setting
up appointments for recalls for Chrysler. Also contacted dealerships with
clients for any other issues with service. 01/12/15-04-09/15
Eligibility Specialist, CFA Staffing (Temporary Assignment)
Responsible for gathering detailed personal and income based information
related to applications for public assistance programs under Family and
Social Services Administration. Requested and reviewed case information,
prepared case for State Eligibility Consultant for approval or denial. Also
initiated calls to and responded to calls from client on daily basis.
08/14-10/14
Grievance Appeal Representative, Aerotek Staffing Temporary Assignment
Responsible for reviewing request from providers and beneficiary's
concerning denials of Medicare claims. Duties includes researching claims
to determine if all required information meets Medicare guide lines for
payments, sending appropriate letters requesting additional information if
needed and/ or reversing denials issuing payment. Updating certificates of
medical necessity upon request from provider with correct documentation
submitted. 05/14-08/14
Denial Management Analyst, KForce (IU Health Revenue Cycle)
Responsible for researching Inpatient and Outpatient denials for Government
Insurance payers. Requesting Retro Authorizations when needed and Appealing
denied services for Medical Necessity and Precertification denials. Duties
also included resubmitting claims and submitting adjustment forms to
manager with over representative limit. Ambulatory Surgery Centers and
Facility Experience. 09/2013-05/14
Medical Accounts Receivable Billing/Follow Up Representative, That's Good
Hr (Surgical Care Affiliates) Responsible for Commercial insurance
billing/follow-up for outpatient Facility and Inpatient Surgical hospitals,
Ambulatory Surgery Centers located in Indiana and Texas. 10/2012- 07/2013
Medicare Accounts Receivable Billing/Follow Up Analyst, Diverse Staffing
(IU Health
Revenue Cycle)
Responsible for Medicare Hmo Follow up and billing for Facility and
Ambulatory Surgery Centers. Research claim rejections and denials for
outstanding balances. Update Patient insurance information if needed.
04/02/12- 05/25/12
Denial Follow Up Representative, St. Vincent Health
Responsible for Commercial insurance billing/follow-up for facility and
Ambulatory Surgery Care Centers. Resolves claims issues with multiple
payers by researching outstanding balances and working with insurance
companies on denied claims. 03/10- 04/02/12
Account Representative, That's Good Hr Temporary Service
Responsible for Commercial insurance billing/follow-up for facility and
Ambulatory Surgery Care Centers. Resolves claims issues with multiple
payers by researching outstanding balances and working with insurance
companies on denied claims. 10/09- 03/10
Medical Billing Specialist, Ciproms
Responsible for collections on patient accounts, updating incorrect patient
information, billing and rebilling insurance if needed, Received calls from
providers, patients, lawyers concerning account information. Verified
eligibly, contacted collection agencies, set up pay plans for patient,
contact insurance for denials, and submitted patient information for
assistance. Adjustments were made to accounts when needed. Sent statements
to patients up on request. Requested Medical records for review and appeal
denials. 01/09-10/09
Pharmacy Medical Billing Specialist, WellPoint Precision RX, Specialty
Solutions
Responsible for resolving billing issues on account balances,
Predetermination and appeals were also a part to this position. Collected
payments from patients, also verified with all Commercial insurance
including Medicaid and Medicare eligibly for specialty medications under
patient plan. Submitted claims, worked edits for claims suspended for
denials. Contacted Insurance Company's for overrides, Requested Medical
records for review and appeal denials. 02/08-01/09
Pharmacy Care Specialist, WellPoint Precision RX, Kelly Services
Responsible for providing patients with excellent customer service,
responding to request for refilling Specialty medications via in bound call
center for mail order pharmacy, also but not including to setting up new
patient's account, commutating with physicians, medical plans, coordinating
delivery dates via UPS. Problem solving was also a tremendous part of this
position. (Temp to hire position) 10/07-02/08
Unit Secretary/Appointment Scheduler, Clarian Health Partners
(Clarian North ER) (IU Medical Center Clinic)
Provided clerical assistance to Emergency Department. Duties included but
not limited to paging physicians on call, calling for transport, making
copies, entering orders for physicians in to system for x-rays, blood work
etc. Also requested bed's for patient when admitted to hospital. 11/05-
11/2007 Continue to work part-time Transferred to IU Medical Center Clinic.
Responsible via inbound call center setting arranging appointments for
patients assigned to physicians at clinic and new patient appointments,
scheduled test for patients ordered by physicians Updated patient's
information as needed. Entered patient charges and posted insurance
payments to patient accounts. 11/2006-03/2007
REFERENCES AVAILABLE UPON REQUEST
Most resent jobs have been with staffing Agencies due to economy after
layoff form permanent position.
Contact this candidate