Customer Service Insurance
Resume:
Shanda Clayton
Houston, TX ****9
Email: ******.*********@*****.***
OBJECTIVE:
To obtain a challenging position that will enable me to utilize, enhance my knowledge and strengthen my skills within the acquired field through my schools and experience.
SUMMARY OF QUALIFICATIONS
Highly motivated, self starter with more then 10 years of customer service experience, and more then 5 years of office experience. Able to work both independently as well as a team environment.Creative contributor of ideas that facilitate business process. Able to prioritize tasks, delegate to others, and organize and motivate a team. Committed team player with demonstrated ability to meet and exceed goals and deadlines. Strengths include:
Medical Terminology *Insurance Verification *Medi-soft
Coding (CPT, HCPCS, & ICD-9 Cm) *Insurance Collection *Microsoft Word
Microsoft Word, Outlook, Excel, Windows NT *Rebill & Appeal *Customer Service
Accounts Payable/ Accounts Receivables * Oracle *Power Point * Lotus *Access
Professional Experience
07/2013 – PRESENT ECARDIO DIAGNOSTICS
Patient Collections
Verify patients insurance
Take credit card payments over the phone
Follow-up on aging patient balances
Process return mail, use system for skip tracing
Make inbound/outbound calls
Go over accounts with patients
Set up payment plans, or request settlement payments
Apply appropriate adjustment types
Maintain a daily goal of accounts worked
Explanation of Benefits including allowed amounts, discounts, in/out-of-network benefit levels, deductibles, coinsurances and co pays
Handle Bankruptcy correspondence
Assist in training new collectors
Apply ICD9 and CPT code knowledge to collection of the patient balances
Apply Ecardio special instructions for processing claims for carries and practices
02/13-03/13 University General Hospital
Phlebotomist
Venipunture of adults and geriatrics
Injections-Intramuscular
Blood Smears and Microscope
Bleeding Time
Capillary
Urinalysis
Specimen Processing
Order of Draw
Blood Cultures
06/10- Present Xam/Max Houston, TX
Job Title- Patient Account Representative
Contact Patients about accounts
Go over account with patients
Set up payment plans with patients
Verify any insurance that patients has available
Answer any questions that patients has about account
Take payments
General duties as needed
08/02-06/10 Wal- Mart Super Center Houston, TX
Job Title-Lead Sales Associate
Assist customers with processing all merchandise sales
Maintain all monetary transactions on assigned registers (cash, credit, debit, and gift cards)
Monitor all inventory and stock area when needed
Assist in various departments as well
General duties as needed
09/09-10/09 Charles A. Garcia MD & Associates Houston, TX
Job Title- Medical Office Specialist ( Externship)
Posted payments from commercial insurance carries as well as personal payments
Contacts insurance companies concerning unpaid accounts receivables.
Secures patient accounts in order to maximize reimbursements in a customer service oriented fashion.
Expedites and maximizes payment of insurance medical claims by contacting third party payers and patients
Follows up on outstanding accounts and makes proper notations
Evaluates if payments were made according to contract
Reviews invoices to verify payments and contractual adjustments
Drafts letters to the insurance company’s Medical Review Board to expedite payment
Investigates and appeals unpaid or partially paid accounts.
Maximizes the efficiency and accuracy of the collection process by up-front collection.
Files insurance claims and requests statements
Education & Training
Everest Institute, Hobby Campus
Medical billing and coding
Diploma received 10/09
Marques Learning Center
General Studies
Diploma Received 05/09
Pima Medical Institute
Phlebotomy Technologist
04/13 Diploma
References Available Upon Request
Contact this candidate