Customer Service Representative
Resume:
Ashley Edwards
Las Vegas, NV *****
***************@*****.***
Accomplished professional with over 15 + years experience as a healthcare billing specialist and customer service representative. I am seeking a position to utilize my strong leadership, communication, interpersonal skills and actively contribute to the growth and well-being of your company.
Authorized to work in the US for any employer
Work Experience
Insurance Billing and Reimbursement Specialist
Professional Billing Solutions LLC - Henderson, NV April 2021 to Present
• Submission of all billing, commercial insurance, MCOs, HMOs, charge entry
• Insurance eligibility verification and patient out of network cost estimates
• Corrected claim submission with the appropriate CPT/ ICD-10 codes, modifiers, POS, TOS, and authorization
• Rebilled claims not on file or lost by insurance and submitted substantiating documentation
• Appeals submission to overturn denied or short paid claims Medical Billing and Collections Specialist
Medical Revenue Solutions - Las Vegas, NV
September 2019 to March 2021
• Responsible for managing accurate and timely completion and submission of all charges
• Submission of commercial insurance, MCOs, HMOs, and patient billing
• Worked directly with the insurance company, healthcare provider, and patient to get a claim processed and paid
• Resolved clearinghouse rejections and denials
• Verified patient accounts for creating payment plan or pre-collections process CSR - Customer Service Representative/Cashier
Bed Bath & Beyond - Las Vegas, NV
July 2017 to August 2019
• Assisted customers with checkout, answered outstanding questions
• Solved billing issues and answered customer inquiries
• Assisted customers with product inquiries, refunds and exchanges, maintaining excellent customer satisfaction rate
Denial Management Specialist
Las Vegas Skin and Cancer Clinic - Henderson, NV
March 2015 to June 2017
• Managed a high volume of claims meeting productivity levels
• Insurance audits on underpaid, overpaid claims with recoupments/ offsets
• Reviewed each insurance payment EOB for accuracy and compliance with contract discount
• Communicated with insurance companies regarding any discrepancy in payments
• Completed and submitted corrected claims and appeals on unpaid accounts Medical Biller/Collector
Heart Center of Nevada - Las Vegas, NV
May 2010 to January 2015
• Entered CPT codes and patient information into billing software
• Reviewed and validated accuracy of charges including dates of service, services provided, location, and authorization
• Worked claims and claim denials to ensure maximum reimbursement for services rendered
• Appeals submission to overturn denied or short paid claims
• Utilized billing software to process financial eligibility, authorization, billing, and denial follow-up transactions
• Posted insurance and patient payments
• Reviewed patient bills for accuracy and obtained missing information prior to generating patient statements
• Communicated with patients to help them understand the reasons for their bill Customer Service Associate/Cashier
Toys 'R' Us - Las Vegas, NV
June 2007 to April 2010
• Conducted sales transactions, processed payments, and managed cash register with zero discrepancies
• Maintain a friendly and welcoming attitude, providing excellent customer service
• Resolve customer complaints with a 97% satisfaction rate Cashier/Customer Service Representative
Walmart - Las Vegas, NV
March 2005 to June 2007
• Processed transactions to date with 100% accuracy, handling cash, credit card, and electronic payments
• Responsible for a balanced cash drawer at the opening and closing of a shift
• Resolve customer complaints and provide expert knowledge regarding products Education
Certified Medical Billing Specialist (CMBS) in Medical Billing & Coding Nevada Career Institute
June 2007 to February 2008
High school diploma
C O Bastian High School - Caliente, NV
August 2004 to June 2005
Skills
• Customer service
• Leadership
• Negotiation
• Data entry
• Patient care
• Communication skills
• Decision-making
• CPT coding
• ICD-10
• Medical terminology
• Insurance verification
• Prior authorization
• Cash register
Contact this candidate