Customer Service Representative
Resume:
JACQUELINE WALRATH
**** ******* **** ** ● Jefferson, Oregon 97352 ● 503-***-**** ● *******.******@*****.*** CUSTOMER SERVICE
EDUCATION & TRAINING
VOCATIONAL DEGREE MEDICAL FRONT OFFICE ASSISTANT June 1993 ROGUE COMMUNITY COLLEGE Grants Pass, Oregon
KEY COMPETENCIES
● Reading Comprehension
● Speaking
● Writing
● Mathematics
● Time Management
● Active Learning
● Equipment Selection
● Installation
● Operation Monitoring
● Active Listening
● Instructing
● Negotiation
● Social Perceptiveness
● Critical Thinking
● Complex Problem Solving
● Troubleshooting
PROFESSIONAL EXPERIENCE
ACCOUNT RECEIVABLE SPECIALIST August 2014 February 2015 KFORCE Portland, Oregon
● Responsible for Insurance follow up on commercial payers
● Managed denied claims and claims still pending within Epic system
● Communicated by email or phone with insurance to discover reason for denial
● Made edits to denied claims
● Handled 40 60 claims per day
CUSTOMER SERVICE REPRESENTATIVE November 2010 October 2013 SWEDISH HEALTH SERVICES Seattle, Washington
● Assisted members with issues involving billing questions and payment processing
● Explanation of EOB and denied claims to members
● Qualified members for financial assistance and initiated application
● Maintained 1 call resolution
● Answered and triaged up to 75 calls per day
● Assisted billing department when needed in managing Worker's Compensation claims CUSTOMER SERVICE REPRESENTATIVE II February 2005 October 2010 WACHOVIA,LLC Salem, Oregon
● Answered customers questions regarding ICS/IRA accounts
● Helped with Retail Phone Bankers when needed
● Assisted with questions regarding financial statements and balances ACCOUNTS RECEIVABLE SPECIALIST June 2003 September 2004 SILVERTON HOSPITAL Silverton, Oregon
● Billing of secondary insurances
● Coordination of benefits with primary insurance to insure accurate payment
● Followed up on denied claims and incorrect payments received
● Worked with commercial payers such as Regence, Humana, Aetna, Medicare and Medicaid CUSTOMER SERVICE SPECIALIST I June 2001 May 2003 REGENCE HMO OF OREGON Salem, Oregon
● Answered customer's inquiries regarding policies and benefits
● Assisted members with billing problems and ways to resolve them
● Walked new members through applications process and assisted with any discrepancies MEDICAL INSURANCE BILLER March 1997 June 2001
SALEM MEMORIAL HOSPITAL Salem, Oregon
● Billing of secondary insurances after Medicare payments
● Experience with CMS 1500 and WC HICFA forms
● Utilization of automated scanning system for document archives MEDICAL INSURANCE BILLER June 1996 February 1997 HOME MEDICAL, INC Medford, Oregon
● Billing of primary and secondary insurances
● Verification of ICD 9 and HCPC codes for accurate billing
● Customer service representative operations and insurance problem resolutions PATIENT CARE COORDINATOR June 1994 March 1995
DR. HELEN TREW Medford, Oregon
● Billing of primary and secondary insurances
● Verification of ICD 9 and HCPC codes for accurate billing
● Back up Office Manager when the Office Manager was not available or away from the office. ACCOMPLISHMENTS & AWARDS
● Medical Front Office Assistant Certificate, 1993 TOOLS & TECHNOLOGY
● Epic System
● Maintain records in standardized data environment
● Utilize multi line phone system
● Bookkeeping and 10 key
● Filing (Color Coded, Alphabetically)
● Utilized standard office machines (Copier & Fax)
● Transcription of Letters, Memos, & Reports
● Effective at working in a team or group or by myself
● Efficient at working with difficult people
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