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Customer Service Associate

Location:
Cumming, GA
Posted:
November 29, 2023

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Resume:

Helen Dippold

ad1j4f@r.postjobfree.com

404-***-****

Healthcare Communication System Conversions Customer Service Testing Training QA Insurance Authorization Regulatory Compliance Denial Management Billing CPT Codes Experience:

Medica Health Care January 2023 – Present

Customer Service Associate III - Remote

• Assist customers with questions regarding coverage options, precertification requirements, billing, physician networks, and non-covered services, price quotes, etc.

• Customer service expert, attention to detail, organization, multi-tasking

• Full and complete understanding of multiple insurance plans, coverage areas and limitations, claims, exception codes, CPT, diagnosis codes, etc.

Maximus Healthcare – Temporary Contract Position – Remote February 2022 – June 2022

• Quality Control Associate

• Assisting the state of Arkansas with backlog of Medicaid eligibility applications

• Full understanding of regulatory requirements needed to ensure eligibility is accurate and complete

• Management of multiple systems and attention to detail

• Ability to work independently and exceed productivity standards Concord Hospital – Concord, NH December 2014 – July 2020 Supervisor– Outpatient Rehabilitation and Specialty Services Business Office Operations

• Management of billing, insurance requirements and denial management for PT, OT, ST therapies, Cardiac and Pulmonary Rehab therapies and Diabetes and Nutrition billing.

• Development of process, procedures, and competencies

• Management of billing and regulatory requirements for all service areas

• Full understanding of all insurances, (HMO, EPO, PPO, HSA, Medicare, Medicaid, Workers Comp)

• Successful conversion of main electronic medical system to new EMR

• Excel in providing excellent customer service to all patients, physician offices and internal and external clients. Experience in handling complaints and questions, providing clarification of benefits and authorization requirements, scheduling appointments and managing workflow across multiple sites, systems and platforms. Education:

Hesser College – AS Business



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