Customer Service Project Manager
Resume:
Cameron Curry
Houston, TX 77068
*******.*******@*****.***
Objective:
My goal is to obtain a position in management utilizing my experience and educational
background with multiple health care settings in an effort to become acclimated with the company
culture as well as perusing opportunities for growth and development.
Skills and Qualifications:
• Strong experience with leadership rolls within the call center environment; possessing
excellent coaching, training, motivational, and management skills.
• Development and implementation of standard operating procedures for multiple job
functions within a call center environment.
• Ability to set and meet performance goals for sales targets, efficiency levels and quality
assurance standards.
• Business development, project management and acquisition experience.
• Comprehensive background with training and development.
• Extensive interviewing and hiring experience with an emphasis on human resource
policies.
• Possesses effective oral and written communication skills.
• Proactive when solving and preventing problems.
• Specialist in quality assurance and quality control methods.
• Very comfortable with working in all versions and aspects of Microsoft Windows.
• Knowledge of EOB’s, CPT and ICD-9 codes, HCFAs, UB92, UB04, HCPCS, DRG’s and
authorizations/referrals
• Hospital, Physician and DME Billing Management Experience
• Proficient in Epic physician and hospital billing systems
• DME Billing (diabetic testing supplies, catheters, walkers, wheel chairs, canes, ostomy,
wound care, oxygen tanks)
• Billing inpatient and outpatient hospital claims and physician office claims
Work History:
05/ 2014-12/2014 Allegis Revenue Group Account Manager/Collections
• Reviewed patient bills for accuracy and completeness and obtain any missing information
• Worked directly with multiple commercial insurance companies as well as government
agencies in an effort to process patient claims
• Followed up on unpaid claims within standard billing cycle timeframe
• Checked each insurance payment for accuracy and compliance with contract discounts
• Contacted insurance companies regarding any discrepancy in payments
• Reviewed EOB’s to determine the reason for denial
• Appealed various types of denied claims including prior authorization, medical necessity,
timely filing, and prompt pay appeals.
• Constructed appeal correspondence for submission to insurance companies
• Placed follow up calls to insurance companies in an effort to check the status of appeal
submission
• Solved all AR discrepancies to completion
04/13 – 04/14 Patient Account Services Call Center Team Lead III
• Supervision of the Customer Service team, Queue Monitor, and Mentors
• Assist with training and development through coaching and one on one’s
• Identify and assist with calls requiring assistance
• Identify and assist with Customer Service Escalations
• Team/ queue scheduling
• Interpreted EOB’s in effort to collect payment from insurance companies
• Followed up with insurance companies is regards to appeals, denials, underpayments
• Billed physician office and hospital claims
• Billed patients balances that are due based on deductible, copayments, co-insurance
• KPI reporting for end of the month AR
• Billed worker’s compensation claims
• Managed insurance collections reps production as well as assigned claims to work queue
• Proactive in reporting any and all issues or concerns that are not conducive to assigned
team and or project that includes all facets of Operations
• Ensure assigned queue opens and closes on time
• Liaison for Customer Service Representatives and upper management team, branches,
and/or company departments.
• Conduct any and all research required in an effort to resolve problems
• Liaison between patients, patients’ relatives, and the health care organization
• Assist Supervisor with client communication
• Coach assigned team in accordance to PAS and client policies and procedures
• Answer questions, handle complaints and properly address problems and concerns
• Answer in and out bound calls, account research, insurance and adjustment identification
to ensure proper account resolution.
• Review, interpret patient statements, balances and Client Contractual Terms/Agreements
• Obtain supporting documentation regarding patient/client follow up efforts
• Identify contractual and administrative adjustments
• Complete requested number of daily call assessments
• Monitor calls
• Mentor and train individuals and team member daily
• Ensure that claims were billed timely
• Communicate, explain and effectively implement/ execute policies and procedures
• Daily Statistics and Reports
• Billed inpatient and outpatient hospital claims
08/09 – 11/12 HDIS Inc. St. Louis, MO. Call Center Supervisor
• Managed external audits representatives whose responsibilities included responding to
Centers for Medicare and Medicaid Service audits as well as outside Medicare Contractor
audits and private insurance audits.
• Created compliance programs and training for all functional area involving diabetic resting
supplies, catheters and incontinent supplies.
• Managed internal audit reps for durable medical equipment products in an effort to adhere
to standards for the Accreditation Commissions for Health Care.
• Successfully managed a call center of 120 representatives as well as the exponential
growth of the customer base to 30,000 new customers.
• Project Manager for pharmacy acquisition that serviced 25 nursing facilities within
competitive bidding areas.
• Project Manager for acquisition that produced over 2,000 additional customers and
equates to $500,024 in revenue growth.
• Developed and implemented standard operating procedures for multiple groups, including
Medical Supply Specialist, Sales and Retention, Customer Service, Physicians Relations
and the QA/QC team.
• Administered Cisco Call Manager, monitored call flow to maximize incoming and outbound
calls and minimize customer hold times.
• Responsible for key metrics including service level, abandon rate, conversion rate and call
quality.
• Submitted DME claims to Medicare, Medicaid, Commercial insurance companies
• Completed Medicare denial, appeals, as well as external audits
• Analyzed errors and coached employees for performance improvements.
• Responsible for developing QA/QC programs for Sales Reps (Medical Supply Specialist).
• Projected forecasting for COGS.
• Owned all aspects of employee scheduling and payroll including review and approval of
vacations and PTO.
• Structured training programs for new product categories based off national and local
coverage determinations
• Implemented training requirements for multiple functioning areas within the department.
• Facilitated compliance program for Medicare, Medicaid, and private insurance
reimbursement
01/07 – 07/09 Goal Oriented Health Care St. Louis, MO. Medical Assistant
• My duties included a host of multitasking between front and back office duties.
• Assisted physician with minor office surgery
• Front office responsibilities included answering phones, registering and scheduling
patient’s appointments, insurance verification.
• Maintained patient’s charts, medical records and correspondence.
• Acted as a liaison between patients, doctors, and insurance companies.
• Back office duties included escorting patients to their rooms, taking vital signs, urinalysis,
injections of medication and patient education.
Education:
Harris Stowe State University 01/05-01/08 Health Care Management
Saint Louis College of Health Careers 03/03-09/04 Medical Assistant
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