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Customer Service Medical

Location:
Long Beach, CA
Posted:
December 10, 2016

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Resume:

Nancy Dee Mesa

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

Rosemead, CA. 91770

Phone: 626-***-**** Email: acxudu@r.postjobfree.com

Objective

Seeking employment as a Direct Support Professional/Caregiver with clinical and administrative responsibilities. Able to multitask, meet deadlines, handling difficult situations in a courteous and a professional manner. Providing service, support, communications and a solution.

Professional Experience

Total Life Care, Inc Covina, CA July 2015 – Present

Direct Support Professional/Caregiver

Providing support to individuals with developmental disabilities the Quality of Life. Knowledge of dual diagnosis, Individual Program Plans, Client service needs, medication, emergency disaster, abuse reporting and behavior plans. Providing active listening, verbal communication, critical thinking, reading comprehensive, teamwork, problem-solving, teaching, social perceptiveness, maintain confidentiality, detailed, flexibility, adaptability, prioritize, able to work in a diverse population, creativity, empathy and concentration. Providing transportation to and from to day program.

The California Mentoring Network City of Industry, CA January 2014 – July 2015

Cole Vocational Services

Direct Support Professional/Caregiver

Providing services, support, a voice, assistance to adults and children with intellectual and developmental disabilities, brain and spinal cord injuries and other catastrophic injuries and illnesses, and to youth with emotional, behavioral and medically complex challenges as well as their families. Helping with daily activities such as meal preparation and planning; medication administration; and personal care. Facilitate community involvement by accompanying individuals on outings in the community or providing transportation to work or other activities. In addition, providing support therapeutic and behavioral plans in partnership with clinical staff to enhance the quality of life for those we support. I use (Sign Language) with some of my clients.

Caregiver/MA Rosemead, City of Industry, Buena Park, CA April 2009 – Present

Provide care for patients 24-7. My patients suffer from Cirrhosis of the liver, Lung Cancer, Kidney, Congestive Heart failure, Diabetes, COPD, Depression, Bipolar, Dementia, Schizophrenia, Down Syndrome, Autism, Multiple Sclerosis, Hyperactive to severe Mental Retardation, Cerebral Palsy, Muscular Dystrophies, Deaf, Mute and providing transportation for Radiation treatment and doctor appointments. My job is to provide Respect, Communication, Empathy, Love, Attention, Service, Support and Care for all my patients. I worked with Kaiser under the Hospice Care Supervisor Priscilla. Which she taught me how to provide care, give medications, change (wounds) dressings, usage of oxygen tanks, change beddings, diapers, monitor and document all necessary information that was needed to provide care for my patients on a daily basis. Assisted in bathing, preparing meals and feeding. Making sure the Quality of Life was Pleasant, Safe and Comfortable.

All Medical Staffing/QTC Medical Services Diamond Bar, CA July 2013 – Sept. 2013

Case Coordinator (Temporary assignment)

Accountable for the timeliness and quality of medical services and reports. Schedule/Reschedule appointments, triage cases, maintain the integrity and organization of case files, e-mail, data entry, phone claimants for appointment follow-ups and signed documents that are needed and or missing. Maintain positive claimant and physician relations. Complete other projects and clerical responsibilities as assigned. Knowledge of medical terminology, medical records/charts, customer service, call center and front desk experience, exceptional interpersonal abilities, organized, detailed, follow-up on time sensitive/urgency documents. Knowledge of E-Process, Excel and word.

The Saban Clinic Los Angeles, CA April 2013 – June 2013

Front Desk Specialist, Appointment Scheduler (Per Diem)

Responsible for accurate registration of patients to various clinical program’s. Maintain and oversee accurate patient demographics, update data in chart and computer as needed. Process, review and document patients discharge from Clinic services. Provide and assist patients with referrals, follow-up, community resources, and specialty care services as needed. Handles in-coming patient telephone calls, schedules appointments and provides accurate information to patients. Demonstrated excellent customer relations, communication skills, ability to listen and communicate with others in a professional and caring manner Self-starter, reliable, and dependable. Knowledge of basic medical terminology. Experience with multi-button telephone, computer and other simple business equipment. Proficient with the Clinic's Practice Management Systems (HEALTH PORT.) The ability to respond with sensitivity to people of diverse cultures and various lifestyles. Responsible for maintenance of all clinical records. Update and purge charts/records as necessary. Maintain/process patients' records and charts in an efficient and timely manner. File laboratory results and any other related documents into patient charts. Prepare and pull patient charts for daily clinic sessions. General clerical responsibilities including typing labels for patient charts. Order and maintain supplies necessary for patient records. Process the release of patient information within fifteen (15) days of request. Handle patient information with utmost respect and confidentiality. Knowledge HWLA, Medical, Medicare, PPO, HMO, DHS, OSHA, and CHDP. Support the Clinic's mission of quality care and patient satisfaction.

Keck Hospital USC Dept. of Surgery Los Angeles, CA December 2012 – March 2013

Support Coordinator/Medical Receptionist (Temporary assignment)

Operates in a high volume, highly structured call center environment by responding to incoming calls. Determines the type of appointment requested or needed, reviews scheduling mix of various physicians/providers, and them makes appointment utilizing appropriate guidelines. Prioritizes member needs and offers alternatives to members when appropriate. Utilizes superior customer service skills to provide service to members when diffusing difficult member encounters.

Uses tact and diplomacy in handling difficult interactions with members. Determine if calls are urgent or emergent by listening to the member, following established guidelines, and then transferring the call to a Registered Nurse when appropriate. Composes messages for physician/providers. Assign new patients/members a primary care physician, processing self-referral requests, calling members to cancel and reschedule appointments. Verify and update member demographics. Record and maintain activity logs. Knowledge of Startel Agent Interface/Polycom, Outlook, Excel, Synapse, Centricity and Word. Clerical and administrative responsibilities.

Care1st/Medsearch Monterey Park, CA August 2012 – November 2012

Member Service Representative (Temporary-assignment)

Responsible for providing high level member assistance by scheduling various appointments requested, transferring calls appropriately, composing messages, and providing general information. Responsible for dissemination of information regarding the Plan and benefit coverage. Resolving member’s complaints and grievances. Verify eligibility of insurance. Responsible for educating members and maintaining individuals in the Plan by providing them with the tools that allow them to access care. Knowledge of the principals and protocols, HMO, PPO, IPA, Medicare and Medical experience including basic medical terminology, in addition to, knowledge and understanding of CMS Guidelines. Inbound/outbound call center experience. (Word, Excel and PowerPoint).

SSD Services Long Beach, CA January 2012 – June 2012

Dealing with patients that have mental, physical disabilities and evaluating clients on a daily basis. Performs secretarial and administrative duties, knowledge of medical terminology and hospital, clinic, or laboratory procedures. Compiles, records, maintains, file medical charts, reports, demographics, and correspondence. Answers telephone, screens and directs calls, schedules appointments, greets and direct visitors. Maintains

files and reports.

Scan Long Beach, CA July 2011 – November 2011

Member Service Representative (BHL) (Per Diem-assignment)

Provided members with Medicare benefits, eligibility and referrals. Answer member benefit inquiries, eligibility issues and provider inquiries in writing, Coordinates with other departments to ensure timely and appropriate responses, Membership changes such as demographics, (PCP primary care physician and Medical Group IPA changes), Handled complaints and concerns of members - escalated calls; to collections and or supervisors when needed Initiate claim adjustments and respond to emails. Responsible for expediting, research, and resolve complex issues. Provided members with quality member/customer care and satisfaction. Maintain members confidentiality on medical charts. Increases member satisfaction and reduces disenrollment by resolving and following up on member issues, complaints, and concerns. HMO, PPO, IPA, triages and/or resolves escalated and/or complaints. Educates members, family and caretakers regarding available and appropriate plan benefits and explain Ambulance services, Coverage, Pharmacy, and Transportation benefits. Maccess, Intranet, Outlook, Power Point, Word and Excel.

Retina Institute of California Arcadia, CA April 2011 – June 2011

Medical Front Desk

Greet patients, process new patients and update demographic information for existing patients, insurance verification (HMO, PPO, IPA, Medicare, Medical), collect co-payments, File medical documents - charts (EMR), answer phones, emails, faxes, schedule appointments, receive deliveries, educate patients on medications and make bank deposits.

The Doctors of USC Los Angeles, CA September 2009 – April 1, 2011

Medical Assistant/Front and Back Office

To assist the doctor, obtain vital signs: Temperature, Blood Pressure, Pulse, Weight, Height, room patients taking the chief complaint/history, collect specimens, administer medication, basic lab test, obtaining medical history, venipuncture, instructing and educating patients on treatments and procedures, cleaning and sterilizing equipment, preparing and maintaining examination and treatment rooms, inventory control and storing of supplies, changing bandages, dressings, and suture removal, where permitted, handling drug refills as directed by the physician, performing EKG’s, front and back office (preauthorization) greeting patients, verifying insurance, taking payments, inputting patient data, answering phones, and returning phone messages. Register patients coming in for treatment/appointments, verify patient demographics, and financial insurance information, from either the patient, family member or physician’s office and facilitates coordination. Knowledgeable of Hospital policies, procedures, HIPPA and PHI regulations. Insurance Verification for all carriers (HMO’s, PPO’s, IPA, Work/Comp, Medicare, Medical, POS plans.) Proficient as a Medical Front and Back Office, medical terminology, and Authorization/Pre-Certification knowledge. Responsible for training externs. The programs used Centricity, EPF, Synapse, Schuynet, Point and Click, Orchard/Harvest, NEXGEN, (EMR) Electronic Medical Records and Trust Commerce which process electronic payments.

ZD Consulting Group, Inc. City of Industry, CA June 2007 – February 2009

Office Assistant/Customer Service/Sales

Greet clients/customers in a professional manner. Scan confidential documents, set-up new accounts and ran the office. Handled accounts receivable, collections (Initiate demand for payments) property management and clerical responsibilities. Prepare correspondence on delinquent accounts. Reduced the number of accounts written off to bad debts. Answering, screening and direct phone calls to appropriate parties without error. Provided solutions to difficult situations.

Drive Medical Pico Rivera, CA November 2005 – March 2007

Customer Service Supervisor

Knowledgeable of (DME) Durable Medical Equipment supplies and there specifications. Duties included order entry, order maintenance; write up orders, mail catalogs, samples, price quotes, respond to customers request via telephone, mail, and /or email, Up sell products/services, analyzes transactions, correct/adjust errors, reports on performance objectives, coaching, monitoring calls, quality control and counseled employees when appropriate. Responsible for managing the office, schedule appointments, arrange executive meetings and their travel plans. Provide support to Customers and Sales representatives on shipments that were ordered and/or cancelled. Handled major accounts such as Apria, McKesson and Providence. Which on a weekly basis brought in over $100,000.00. Recognized for working well with others. Programs used MAS200, EDI’s, Excel, Windows, 10-key by touch, processed freight quotes, tracking information/process shipments through UPS and other carriers. Call center environment/ACD line experience – answered 100 calls daily. Input daily sale orders, fax, HCPCS codes, EDI”S, RMA (return merchandise) Supervised and trained over 25 employees.

GE Finance Assurance Covina, CA January 1996 – August 2003

Customer Service/Quality Assurance Representative

New marketing programs every month responsibility to cross and up sell: Life and Health Insurance, Medical, Dental (Smile Saver), Vision, Pharmacy benefits, Legal, Juvenile and Whole Life Policies, Auto Chevron, (EXXON/MOBILE), AARP plans, Security Protection plans on credit cards. Input client’s data and confidential information (Billing, credit, debits, claim adjustments, enrollments and securing sales.) Quality Assurance and monitoring phone calls. Provided customer service, answer questions, concerns, resolving membership issues with accounts via phone and trained associates on policies and procedures.

Education

UEI College El Monte, CA 02.26.10 – 9.16.10

Medical Assistant

Certified by AHA for CPR Sterilization and aseptic techniques

HIPAA Certification of Training Trained in OSHA standards

General practice and specialties Completion of Medical Assistant training

Clinical Skills

Vital Signs Urinalysis Sterile Tray Set-up

Patient Examination Preparation Capillary Testing Autoclaving

Visual/Audio Screening Injections Venipuncture

Electrocardiograms HGB/HCT Audiometry

Culture/Specimen Collection Pap Smear Set up

Franklin Career College Norwalk, CA 10.08.07 – 02.08.08

Medical Billing and Coding

Medical and Dental Office Administration Medical and Dental Terminology

A&P, Practical Medical & Dental Billing Practical Computerized Billing

Dental Claims Billing General Office Procedures

Garfield High School East Los Angeles, CA 09.11.78 – 06.21.81



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