Customer Service Insurance
Resume:
Crystal Nichols
PO Box *** ~ Princeton, NC ***** ~ 919-***-****
acqe6v@r.postjobfree.com
OBJECTIVE
Management and customer service position allowing for parlay of demonstrated organization, management, customer support, and communication skills proven by 20 years of employment. Skilled at assessing client needs, recommending strategies that enhance efficiency, implementing solutions, and training/supporting staff.
RELATED EXPERIENCE
9/2014 – Present Fayetteville Family Medical Care Fayetteville, NC
Business Office Supervisor
+Supervise Business office staff, which included insurance billing, patient billing, & referrals
+Develop, maintain, and implement A/R policies and procedures
+Oversee patient collections and policies
+Work with staff to identify trends in billing issues/denials
+Develop and implement billing staff performance audit
+Assist with reports and projects as requested by Practice Administrator
+Proficiency in NextGen
4/2012 – 05/2014 Wayne Health Physicians Goldsboro, NC
Billing Supervisor
+Monitors activities of all billing staff for efficiency and accuracy for four practices. Audit and identify insurance procedures that are inefficient. Make recommendations for corrective action.
+Helps to develop and implement policies and procedures to improve operating efficiency within the billing department.
+ Assign staff workload and adjust as necessary. Cross train of all staff and rotate positions periodically to ensure all positions are effectively managed.
+ Discuss performance issues in a timely manner. Conduct annual reviews for all billing personnel.
+ Primary resource for Care Tracker, the practice management software, through all phases from Front Desk, Billing, and administration.
+ Train new employees and educate current staff in ways to be more efficient in Care Tracker.
+ Interact effectively with 7 office managers, clinical supervisors, and front desk supervisors to ensure consistency of shared duties (i.e. collecting revenue, loading insurance, and managing medical documentation). Promote cross training and afford time to achieve this process. Be the resource for all Care Tracker, billing, and insurance questions.
+ Assist in preparing financial and statistical reports for office managers, executive director, accounting, and finance department.
+ Assist in the implementation of new practices into WHP and the billing department.
+ Post charges and reimbursement in Care Tracker as needed
+ Process refunds and return checks for WHP practices
+ Coordinate vacation and personal time of the billing department and arrange for coverage within the department
7/2008 – 4/2012 Carolina Therapy Services, Inc. Dunn, NC
Outpatient Billing Specialist
+ Managed the accounts receivable for 8 outpatient facilities
+ Coordinate scheduling with therapists and therapy appointments for 8 outpatient facilities
+ Responsible for billing primary & secondary insurances, as well as patient billing
+ Posting all payments received and resolving claim denials
+ Tracking of all claims filed to ensure all payor sources are billed & payments received
+ Enter in all insurance and patient info & prepare patient files
+ Verify insurance and authorization to determine eligibility for therapy services
+ Producing weekly & monthly financial reports of claims billed, pain, written off, etc…
+ Manage Medicaid, CDSA, & Tricare referrals and authorization
+ Credentialing all outpatient therapists & various agencies
+ Monitor updates related to payment of claims, changes in claim filing procedures & forms
4/1999 - 8/2007 Misys Healthcare Systems Raleigh, NC
Senior Application Product Specialist, Tech II
+ Provided ongoing software and technical support for the Misys PM and Tiger software, which specialized in medical practice management.
+ Demonstrated ability to analyze and troubleshoot software and hardware problems
+ Knowledge and experience of UNIX/AIX operating systems, personal computers, and printers.
06/93 - 12/1997 IBM Corporation Raleigh, NC
Customer Support Representative
+ Responsible for pursuing cash collections for customer accounts that were assigned.
+ Point of contact for the customer in order to resolve issues raised from invoicing.
+ Demonstrated ability to analyze and troubleshoot invoicing issues prior to customer dissatisfaction.
EDUCATION
5/1993 Meredith College Raleigh, NC
Bachelor's Degree -- Mathematics
EMPLOYMENT HISTORY
FAYETTEVILLE FAMILY MEDICAL CARE – Fayetteville, NC
Business Office Supervisor, 2014 - Present
WAYNE HEALTH PHYSICIANS – Goldsboro, NC
Billing Manager, 2012 - 2014
CAROLINA THERAPY SERVICES – Dunn, NC
Outpatient Billing Specialist – 2008 - 2012
MISYS HEALTHCARE SYSTEMS -- Raleigh, NC
Senior Applications Product Specialist, Tech II, 1999 - 2007
US ARMY -- Ft. Leonard Wood, MO -- Specialist, 1998
IBM -- Raleigh, NC -- Customer Support Representative, 1993 - 1997
Contact this candidate