Eligibility Call Center Representative
Resume:
Troy Nguyen
***********@**.***
Objective: To succeed in an environment of growth and excellence and earn a job which provide me job satisfaction and self-development and help me achieve personal as well as organizational goals.
Experiences: Harris Health System (2010-present)
Position: Eligibility Call Center Rep (2013-present)
Answers telephone calls regarding eligibility services.
Takes appropriate action to resolve client problems or complaints.
Determines if patient has third party coverage and informs patient of all necessary documents in order to complete their eligibility process.
Screens all calls received and determines if patient is a resident of Harris County (informs non-residents of other resources available to them).
Monitors and reports all operational and procedural problems and patterns.
Assigns new MRN to patient if needed and updates changes in patient information.
Position: Patient Access Call Center Rep (2010-2013)
Schedules patient appointments and enters required information in the computer system in an accurate and timely manner.
Obtains demographic, insurance and financial information from patient or guarantor. Enters information in computer system with a high degree of accuracy.
Explains all required forms to the patient or guarantor and obtains the necessary signatures.
Ensures medical necessity compliance by obtaining necessary data, reviewing Compliance System, communicating information to patient or guarantor and obtaining necessary signatures.
Verifies insurance eligibility and benefits and ensures all notifications and authorizations are completed within the required timeframes.
Posts payments in the computer system and generates the appropriate patient receipts.
Monitors, reviews and resolves patient account issues on assigned reports.
Communicates in an effective and professional manner with Physicians, ancillary departments, nursing units, physicians' office staff, insurance companies, as well as patients and their families (all Patient Access customers).
Completes thorough and accurate documentation.
Popeyes Corporation (2005-2009)
Position: Shift Manager
Leading & motivating a team to carry out daily tasks to effectively run a business.
Controlling day to day operations by scheduling labor, ordering food and supplies, building sales to meet and exceed store plan.
Ensuring that health and safety codes, and company safety and security procedures are followed.
Maintaining inventory, managing labor, reviewing financial reports.
Ensuring compliance with all Human Resources practices and applicable labor laws. Conducting performance appraisals, motivating, and training entire team.
Special skills:
5 and plus years of experience providing customer service and support in busy call center environment.
Analytical, Medical Terms, PC, Typing 60 wpm, and Word Processing.
Bilingual: English and Vietnamese.
Excellent with Excel, Powerpoint, Word, Access, Outlook.
Understanding and experience with SQL, HTML, CSS, Java Script preferred.
Business experience in healthcare operation.
Knowledge and experience working with EPIC, Sharepoint, and PeopleSoft software.
Flexible team player with strong teamwork effort.
Working well under pressure and stressful environment.
Strong background in coding specially with Python, and Visual Basic Studios.
Self-Motivated and willingness to learn.
Education:
Bachelor Degree in Computer Information System (CIS) at UHD
Alief Taylor High School (Graduation GPA: 3.6)
References:
Former Supervisor (Kirby): Terry Hobbs 713-***-****)
Current Supervisor (Southeast): Sandra Sinegal 713-***-****)
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