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Customer Service Insurance Verification

Location:
Gainesville, GA
Posted:
December 10, 2023

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Resume:

TONYA MCCLUSTER

**** ************* ****** ****, ** 30554 470-***-**** ad1uha@r.postjobfree.com

PROFESSIONAL PROFILE

Customer service oriented professional with strong leadership skills; facilitates efficient workflows and communicates effectively with co-workers, patients and staff. Follows policies, procedures and guidelines to ensure consistent quality. Maintains and safeguard patient privacy and confidentiality.

Remain flexible and prepared to adapt to various situations

Function independently with minimal direction and guidance

Well-organized, manages time and priorities in multi-task environments

Microsoft Office / MS Excel MS Word MS PowerPoint Typing Speed: 40 WPM

SUMMARY OF QUALIFICATIONS

Insurance Verification Insurance Billing Procedures Medical Office Procedures Appointment Scheduling

Electronic Health Records (EHR) Electronic Medical Records (EMR)

Medical Coding (ICD-10-CM, HCPCS, CPT) Business Office Operations Medical Terminology

Account payable, Account receivable Payroll Banking Systems Healthcare Law HIPAA Compliance Charting Filing

Processing Co-Payment Human Resource Management Organizational Improvements

CMS1450 UB04 CMS1500 Healthcare Claim Cycle Insurance Verification

Medical Practice Management Systems Practice Structure Leadership & Management Anatomy & Physiology

EDUCATION

Ultimate Medical Academy Associate of Science Degree – Medical Billing and Coding, 2021

Ultimate Medical Academy Associate of Science Degree – Healthcare Management, 2019

Medicare Fraud & Abuse Medicare Billing 837 I Form CMS-1450

Daly’s Trucking School/Class A CDL

2023

RELEVANT PROFESSIONAL EXPERIENCE

U.S. XPRESS Enterprise Inc. Ellenwood GA

09/2023- current

Drive and operate trucks.

Follow instructions; locate and read location and road maps.

Pre-inspect truck. Post inspection

Pick up goods and materials, verify loads for accuracy, and deliver them as instructed.

Load and unload cargo.

Responsible for basic vehicle maintenance; comply with all safe work practices, policies, and processes at all times.

Complete and verify paperwork for accuracy

Update job knowledge by participating in educational opportunities, reading professional publications, maintaining personal networks, and participating in professional organizations.

William-sonoma Braselton GA

03/15/2022- 07/31/2023

Administration- schedule loaded trucks to be unloaded at dock doors inbound departments. Morning reports, create shipments close shipments for receivers. fixing receivers problems. forklift driver Stand up Reach. set down swing, Pacer Pick pallets feed narrow aisle or pick up pallets to Put away in wide aisles.

MCI Iowa City IA-departments.

12/22/2020- 03/21/2022

Scheduling appointment, for Vaccine. Taking calls for COVID-19 Hotline Taking payments, Routing calls to desired destination, transferring calls to over 21 different departments. Account payable, Account receivable business to business.

People Ready, Inc. ǀ Amazon – Gainesville, GA 05/2012 -2023

Assistant Manager

Assign individual shift goals to employees and follow-up to ensure delivery of goals

Calculate time at the end of day with head-contractor and fill in for District Manager at Amazon when needed

Make sure that all People Ready employees were fully packaged

Complete follow up calls with employees on a nightly basis

MIG welders measure, cut, and assemble metal projects using an electric arc and inert gas. They select suitable material, ensure the work area is safe, prepare metal surfaces, determine gas ratios, and inspect weld strength during and after the welding process.

Concierge Contact Center – Athens, GA 12/2019 – 08/2020

Medical Scheduler – Call Center

Communicated with patients, doctors and medical staff via inbound and outbound phone calls

Scheduled dental and vision appointment for patients of multiple medical practices

Verified insurance coverage and collected payments

Managed patient profiles and abided by HIPAA guidelines to safeguard confidentiality

CSL Plasma Center – Gainesville, GA 06/2019 – 10/2019

Donor Support Technician

Prepared the donor, donor area and equipment

Monitored donor during process and responded to specific alarms that may occur

Maintained a clean, efficient work environment and followed all health and safety procedures

ADDITIONAL PROFESSIONAL EXPERIENCE

CRC Staffing ǀ Metabo Tools – Braselton, GA 10/2019 –04/2020

Quality Control / Processor

Processed and prepared orders for shipping, and effectively communicated with pickers to ensure accuracy

Managed customer orders, completed data entry duties, resolved order issues, and processed changes

Maintained safe operating environment and worked effectively in a fast-paced, deadline-driven environment.

Hall County Board of Education – Gainesville, GA 01/2016 – 06/2019

School Bus Driver

Transported students to and from school and related events

Remained alert in heavy traffic or bad weather, and followed safety rules and regulations

Prepared and submitted reports, and maintained order on the bus

VOLUNTEER EXPERIENCE

Gateway Thrift Store – Gainesville, GA 03/2018 – Present

Volunteer

Stock inventory, tag new donations and dispose of old donations

Perform light housekeeping duties

Considerate and prepared to compromise occasionally to ensure any conflicts are resolved



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