Customer Service Insurance

Ava Randle

**** ******** *****

Houston, TX. ****5

Phone: 713-***-**** / 832-***-****

Email: *********@*****.***

OBJECTIVE: To utilize and enhance my administrative and customer service skills.

PROFILE: Dependable, result oriented professional with experience in administrative and customer service management. Work extremely well in a fast paced work environment. A committed motivator in supervising staff to maximize productivity. Works well independently while being a team player.

WORK EXPERIENCE:

5/2012 - 10/2014 Memorial Southeast Hospital

Unit Secretary

Entering Doctors orders for patients in system. Updating patient information

and status into system. Making new patient charts and room assignments and breaking down charts.

Filing documents and updating different documents. Answering phones,

paging doctors, Consulting new doctors on patients. Making sure that

Patient board is updated with nurse assigned and rooms assignment.

Ended of day reports on patients and giving nurse assignment for next shift.

Chart and document filing, making copies, spread sheets, using printers and

answering phones.

03/2010 – 4/2012 Primecare Medical Group

Business Office Coordinator

Insurance verification and authorization, input of insurance information and patient demographics, posting payments via paper checks and electronic remittance, creating and submitting primary and secondary claims, check in and out patient, daily deposits closing, answers phones, scanning documents, scheduling new and establish patient appointment, collecting co-pays and balances, AR reports, produce and mail out patient statements, set-up patient medical record, worked on special projects, utilized Eclinical Works and coordinate drug representatives appointments

Filing, making copies, spread sheets and other documents.

01/2006 – 09/2008 The Methodist Physician Organization

Department of Gynecology & Obstetrics

Clinical Coordinator

Implemented procedures and policies for front desk and clinic, scheduling for new patients, checking patients in and out, input insurance information and patient demographics, input charges and reviewing ICD9 Codes and Procedures Codes, pre-certify surgical procedures and entering surgical procedure into Aethna, collect and post surgery deposit and copay’s, daily bank deposits, balance and close end of day clinical closing, processed check request and time sheets, utilized PWL eligibility and benefits, running time of service reports, assigned special projects, utilized Eclinical and Aethna systems.

05/2000 – 03/2005 Baylor College of Medicine

Scott Department of Urology and Neurology

Account Representative II

Reviewed and managed all Pediatric outstanding insurance payments, patient balances and correspondence for Medicaid, Commercial, Manage Care and secondary carrier’s, contact insurance carriers and patients regarding claim status, educate the physician and staff on billing/coding issues that are carrier specific, research and review claim edits/denials and reprocess with corrected information or medical documentation, reviewed claim status and eligibility on PWL and TMHP, utilized IDX Ecommerece edit system and refilling corrected claims electronically through EDI system, researched and processed patients insurance carriers, reviewed account for Revcare (Bad Debt), utilized IDX system.

EDUCATION:

ProMed Training Center June 2005

ICD 9 and CPT Coding Certificate

Texas Southern University 1985-1987

Major: Business Administration

Jesse H. Jones high School 1981-1984

Diploma

COMPUTER SOFTWARE

EXPERIENCE: MS Word, Excel, PowerPoint, Adobe, Outlook, PWL, IDX, Ecommerce, Revcare, Eclinical Works

Reference Upon Request

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