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Customer Service Managed Care

Location:
Nashville, TN
Posted:
December 18, 2023

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Resume:

Anneka Bond

Medicare B/Customer service Specialist II/Web support Technician

Nashville, TN 37207

ad12qy@r.postjobfree.com

+1-615-***-****

I am a friendly, outgoing, ambitious, dedicated individual who has willingness to thrive toward continual success in any given environment. I have extensive experience in Customer Service, Collections and an excellent communicator in Medical and Commercial industries. Work Experience

Senior Patient Access Representative

Accredo Health Group - Remote

September 2021 to Present

Review referral documents for prior authorization submission, and investigate the patients benefits for meeting criteria for therapy requested by physician. Managed Care Operator

State of Tennessee - Nashville, TN

January 2008 to October 2012

Nashville, Tennessee)

Answer incoming local and long distance telephone calls from TennCare/Medicaid applicants, enrollees, provider (e.g., physicians, hospitals, pharmacies), staff from managed care organizations, and other interested parties; respond to questions in areas such as TennCare eligibility, managed care organizations assignment, premium/income information, monthly statements, and covered services; may make outgoing calls to TennCare applicants, enrollees, and providers as necessary for outreach and follow up.

Identify changes that need to be made to TennCare recipients' files; gather information from recipients, applicants, and providers about changes in recipients' files; read information about recipients in computer files; ask recipients about issues such as adding new children to family coverage, changing premium amounts, changing address, and changing managed care organizations. Perform a variety of clerical work: copy TennCare files and eligibility forms; fax TennCare eligibility forms to providers and other departments; file TennCare documents from recipients; mail correspondence to recipients; date stamp all incoming correspondence received; type information received during calls from recipients, providers or applicants into computer files. Work Experience

Collector

Robinson, Reagan and Young LLC - Nashville, TN

August 2007 to January 2008

Collected and monitored past due accounts for Bellsouth and Comcast Cable Evaluated and developed payment arrangements on outstanding receivables ensured anticipated receivables' on credit cards and checking accounts on debtors of Bellsouth and Comcast Cable. Cash Office Administrator

AJ Wright Department Stores - Nashville, TN

September 2005 to June 2006

Coordinated production of all printed materials. Assisted subordinates and supervisors in operations of the store. Developed rules and regulations and polices of proper cash office procedures. Identified and resolved problems on cash handling procedures. Coordinated sales reports and produced accounting reports for General Manager. Forecasted sales with successful analysis of product distribution. Performed, implemented and interpreted all procedures of the Cash Office and Operations Departments of A.J.Wright department stores.

Front Desk Supervisor /Guest Services Representative Springhill Suites by Marriott - Nashville, TN

November 2003 to July 2004

Facilitated guest by checking in the hotel and any activities desired. . Assisted Sales Agent in planning and execution of booking of upcoming events, and any desk assignments required. Promoted Front Desk Supervisor within Three months of employment. Supervised professional and sub-professional staff. Monitored employees' work activities; Assigned work responsibilities to staff; conducted performance evaluations for six staff members; interviewed and hired staff for the front. Developed employees' schedules and processed their time-off requests. Produced various sales reports and hotel disposition reports to the General Manager of the hotel. Medical Collector/Front Desk Clerk

Healthcare Financial Staffing - Brentwood, TN

April 1999 to November 2003

Assigned to various medical billing offices, predominantly, at Vanderbilt Medical Center. Maintained patient records and scheduled appointments for surgery. Verified Medicaid and Medicare eligibility on surgery patients coming into the hospital. Identified any insurance errors that were billed and maintained patients' hospital records with any additional surgery orders from physicians and surgeons. Account Reimbursement Specialist

Vanderbilt Medical Group - Nashville, TN

April 1998 to April 1999

Billed and collected on all insurance claims (Commercial, Medicare and Medicaid, and Champus) of the Thoracic/ Cardiology doctors at Vanderbilt Medical Group Practice. Billed up to 200 patient accounts for Medicare, Medicaid and third-party claims; gathered any necessary credentials concerning billing of medical health insurance. Evaluated system-generated operating records and reports, and verified that the information was accurate for posting of accounts receivables'.

Collector

Ranstad Staffing - Nashville, TN

May 1995 to March 1998

Assigned to various Doctors offices and medical billing offices as a temporary employee. Collected on patients' accounts, billed Medicare and Medicaid and any commercial claims required for payment from doctor's visits and hospital claims.

the" Top Medicare collector" in our office at IPN Network Medicare Biller for IPN Network.L.P - Nashville, TN May 1994 to April 1995

Nashville, Tennessee)

Billed and collected claims for the Southeast regional network service providers. Promoted to the" Top Medicare collector" in our office at IPN Network. Collected over 10 million dollars in outstanding accounts receivables claims due from Medicare and third party payers. Education

Bachelors in Healthcare Business Administration

Ashford University - Clinton, IA

Skills

• CPR

• Documentation

• Microsoft Excel

• Outlook

• Time Management

• retail sales

• training

• Managed Care

• Medical Billing

• Cerner

• Medical Collection

• Property management

• Sales

• Cash handling

• Guest services

• Training & development

• Documentation review

• ICD-10

• Cash register

• Retail sales

• Accounts receivable

• Customer service

• Leadership

• Section 8

• Medical records

Assessments

Customer Focus & Orientation — Proficient

August 2019

Responding to customer situations with sensitivity. Full results: Proficient

Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.

Additional Information

Computer Skills

Word, Excel, Computer skip-tracing, Power Point, Microsoft Publisher, CRT, and CPU usage, Media Players, and Most Microsoft applications



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