Customer Service Assistant

Bertha Duplichien

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

Houston, TX 77053 832-***-**** or 832-***-****

Customer Service Team Lead with over 10 years of experience in a Call Center setting. Consistently achieve record-high customer satisfaction.

Areas of Expertise

Verify Eligibility for Benefits Adheres to all HIPAA and PCI compliance regulations.

Interviewing Clients Understanding the claims in Epic system

Communication skills oral and written Resolve Problems and Complaints Explain Program Benefits

Resource Staffing/HCTRA Customer Service 09/16/2013 to Present Houston, TX

Utilize customers personal information to open an EZ tag account

Answer incoming calls in a fast pace call center (90 to 100 calls)

Process payments for account holders and non-account holders

A C S Patient Account Lead 08/11 to 09/01/2013 Houston, TX

Inbound outbound escalation calls regarding customer claims not processed and paid correctly

Collections on pass due acct

Explain all required forms to the patient of guarantor and obtain the necessary signatures

Obtain demographic, insurance and financial information from patient or guarantor.

Credentialing and re-credentialing provider information, Obtain necessary information to credential provider files using automated online and hard copy sources.

Neighborhood Center Case Specialist 06/04 to 07/2011 Houston, TX

Interview clients; gather information to determine eligibility for service.

Assist client with contacting agencies to get assistant in getting bills paid

Assist clients with coming self-sufficient again

Assist clients with filing paper work needed to get assistant from the state

Visit clients home to check living arrangements

Documents case records using automated equipment to form a record for each client

United Behavioral Health Intake/Insurance Verification 07/00 to 03/07 Houston, TX

Accepts incoming phone calls to resolve the patient’s concerns or questions immediately

Provides follow-up for issues that are not solved on the incoming phone call

Communicates with other Hospital and PO Departments to ensure issue resolution for inbound callers

Is responsible for acting as a liaison between the Hospital and the Physician Organization

Demonstrates analytical skills required to bring the account for resolution

Education:

Worthing Senior High Graduated 1988 Diploma received

Hargest vocational College Graduated 1991 Diploma received in Medical Records

Texas School of Medical and Dental Careers Graduated 1993 Diploma received in Claims Processing

M & M Word Processing Graduated 1995 Diploma Received in Insurance Billing

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