Customer Service Representative
Resume:
Veronica Hudson
Millington, TN ***53
Cell 901-***-****
*********@*****.***
** *****’ experience in customer service, problem solving and research. Experience in insurance guidelines and Medicare/Medicaid, program development, quality improvement and program monitoring.
Education and Training
EDI, Commerce, State Technical College, Memphis, TN
Microsoft Excel 2003 Intermediate / Advanced
Microsoft Office
XCELYS Subject Matter Expert (SME)
Cisco IP Phone 7960 Series
Customer Focus
Remedy
Professional Experience
Forest Hill Cemetery Jan 2013 to present
Contract processing and quality control
File Maintenance
Payroll Responsibilities
Banking duties- cash receipts entry, deposit slips, and bank deposits.
Accounting Duties (A/P, Billing, Deposits)
Deed and Certificates Processing
Maintain records of all memos, e-mails, corporate policies, and programs implemented
Aid and Assist at Home July 2012 to Sept 2013
Build and maintain a relationship between the agency and the MCO Case Management staff to facilitate resolution of issues as they arise.
Serve as the initial point of contact for the field staff of Resource One in an effort to prevent miss communication, scheduling and billing errors.
Monitor and master the Electronic Visit Verification dashboard software system
Update dashboard with current authorizations from MCO’s for home visits.
Keep staffing current on dashboard as notified by Team Leads.
Track Billing and Payroll errors as relates to EVV, reporting to Supervisor unresolvable issues
Keep Electronic Time Sheet reporting.
Collections
Scheduling
Resource One Medical Staffing (September 2011 to July 2012)
Electronic Visit Verification (EVV) Specialist
Build and maintain a relationship between the agency and the MCO Case Management staff to facilitate resolution of issues as they arise.
Serve as the initial point of contact for the field staff of Resource One in an effort to prevent miss communication, scheduling and billing errors.
Monitor and master the Electronic Visit Verification dashboard software system
Update dashboard with current authorizations from MCO’s for home visits.
Keep staffing current on dashboard as notified by Team Leads.
Track Billing and Payroll errors as relates to EVV, reporting to Supervisor unresolvable issues
Keep Electronic Time Sheet reporting.
Scheduling
WR Community Services
Data Entry Specialist (April 2011 to September 2011) LAYOFF
In charge of setting up scheduling according to state authorization ( for Homemakers,Personal Care and Attendant Care and Respite Care )
Communicating the set schedule to members and staff
Keeping track of all issued authorization
Medical Billing Keeping
Payroll and daily calculation of hours in Sandata
Handling all members and staff and Area Managers concerns
Performing all basic clerical duties as needed
Scheduling
Amerigroup Corporation (formerly Memphis Managed Care) Company Closed
Memphis, TN 1994 – 2009
Business Analyst (2006 – 2009)
Maintained over 160K eligibility records in Diamond system mainframe and State of Tennessee - TennCare insurance files.
Managed operator security for mainframe users in regards to Federal HIPAA regulations.
Tested all Diamond system improvements before production.
Produced SqL, Access and Proclarity software for all reporting and recording systems.
Eligibility Coordinator (1995 - 2006)
Designed original company Family Care Health Plan intranet and website.
Generated, monitored and maintained eligibility reports for over 180K members, including uploading patterns and all data into mainframe reporting systems and manual entries.
Managed complete scope of eligibility data including pattern identification and event marketing.
Served as department liaison regarding in- and out-patient services.
Customer Service Representative (1994 - 1995)
Maintained and disseminated company Family Care Health Plan information to enrollees, providers and community.
Maintained quality statistics at over 98% as required by the State of Tennessee - TennCare regulatory guidelines.
Tracked PCCM (Primary care case Managers) changes, developed eligibility spreadsheets and served as department liaison to IS / IT department.
Knowledgeable In
Medicare / Medicaid Guidelines
HIPAA Standards
State of Tennessee Insurance Regulations
XCELYS Claims Processing System
References
Upon request
Contact this candidate