Customer Service Medical Support
Resume:
TENIKA
LAMONS
TELEWORK CUSTOMER
SERVICE/MEDICAL OFFICE
ASSISTANT
********@*****.***
El Paso, TX 79934
CONTACT
SKILLS
• Customer Service
• Organizing Service Schedules
• Employee Timesheet Processing
• Timely Processing
• Administrative Support
• Entering Patient Data
Seasoned Lead Medical Support Assistant at William Beaumont Army Medical Hospital, adept in patient data entry and administrative support. Proven track record in enhancing customer service and streamlining service schedules, boasting a history of leadership and strong interpersonal relationships. Expert in HIPAA compliance and adept in multi-department collaboration for optimal patient care. PROFESSIONAL SUMMARY
Lead Medical Support Assistant
William Beaumont Army Medical Hospital, Fort Bliss, TX Medical Support Assistant (OA)
HQs US AMEDDAC Bamberg Health Clinic, BAMBERG, GERMANY EXPERIENCE
August 2014 - Present
Entered data into databases accurately while ensuring accuracy of information entered.
•
Scanned documents into computer systems using appropriate software applications.
•
Ensured compliance with HIPAA regulations when collecting, entering, and
• storing private patient information.
Provided leadership and guidance to junior medical support staff, training them in office procedures and protocols.
•
Collaborated closely with other departments within the organization to ensure seamless operations.
•
Organized meetings between physicians and other healthcare professionals as
• needed.
Utilized excellent interpersonal skills to build strong relationships with patients, physicians, and other healthcare professionals.
•
Resolved customer service inquiries in a timely manner while demonstrating exceptional customer service skills.
•
Advises patients of alternate Health care on TRICARE. Capable to look up lab
• results, radiology reports, medication summaries, and make telephone consults. Proficient in booking appointments by phone and in person for the clinic, referrals, self-referrals, physical therapy, optometry, hearing, immunization, Warrior Transition Unit (WTU) soldiers, Behavioral Health patients with the proper protocols, and with assisted in the Exceptional Family Member Program
(EFMP) for family members who has a diagnosed a chronic illness.
•
August 2012 - May 2014
Organized meetings between physicians and other healthcare professionals as needed.
•
MEDICAL CLAIMS PROCESSOR
BIENVIVIR SENIOR HEALTH SERVICES, EL PASO, TX
Claims Quality Auditor
FORESIGHT TPA INC, EL PASO, TX
Utilized excellent interpersonal skills to build strong relationships with patients, physicians, and other healthcare professionals.
•
Resolved customer service inquiries in a timely manner while demonstrating
• exceptional customer service skills.
Register or update patient demographic information in the mini registration to ensure data base system is always current and accurate. Responsible for checking patients in for appointments and verifying their identity.
•
Inform patients of other health care, telephone numbers, clinic hours, complaint procedures, transportation, and medical record requirements. Advises patients of alternate Health care on TRICARE. Capable to look up lab results, radiology reports, medication summaries, and make telephone consults.
•
Responsible for answering multi-line phone calls and securing appointments for patients in (Composite Health Care System. (CHCS ). Revised telephone recorded message after same day appointments are booked to inform patients that the Patient Appointment System is closed and includes the appropriate instructions as to when patient can call back for the next available appointment.
•
Responsible and proficient in booking appointments for the clinic, referrals, self- referrals, physical therapy, optometry, hearing, immunization, Warrior Transition Unit (WTU) soldiers, and the proper protocols for Behavioral patient and managing referrals.
•
Assisted in The Exceptional Family Member Program (EFMP) paperwork
(DD5888 and 7426 forms) for family members who has a diagnosed physical, intellectual, or emotional condition. Assisted wherever I was needed.
•
August 2009 - April 2012
Maintained a high level of accuracy in reviewing and verifying claim information
• to ensure proper reimbursement.
Utilized problem-solving skills to identify issues that could affect payment or processing of claims.
•
Reviewed denied claims in order to determine if additional information is needed before resubmission or appeal process can be initiated.
•
March 2003 - December 2008
Conducted audits on claims processing systems to identify errors and
• discrepancies in documentation.
Conducted audits on a daily basis for accurate data entry and payments according to the providers contract. Maintained performance guarantee standards according to contracts with providers.
•
Provided feedback and training to staff on best practices for accurate claim processing.
•
• Investigated customer inquiries concerning coverage eligibility or benefit levels. Utilized a variety of software programs including Microsoft Office Suite for data analysis.
•
Developed quality assurance plans to monitor performance of claims processing staff.
•
Certificate in Medical Office Specialist/ Medical Billing International Business College, El Paso, TX
High School Diploma
Stephen F. Austin High School, El Paso, TX
EDUCATION
August 2001
GPA 4.0
Relevant Coursework
• Medical Billing
Awards & Honors
• Valavitorian
Extracurricular Activities
• National Honor Society
June 1994
GPA 3.5
Amberly Lewis — US Army
NCOIC Patient Administration
*******.*.*****@*****.***
Lakisha Yarbrough-Wyche — Veterans Benefits Administration Claims Processor
*******.*********@**.***
Elizabeth Brink — Mercy Hospital Springfield
RN BSN
**********@*****.***
REFERENCES
Supervisor
Supervisor
CO-WORKER
Able to utilize the Composite Health Care System (CHCS), Military Health System (MHS), Armed Forces Health Longitudinal Technology Application (AHLTA), HAIMS medical records, Medical Protection System (MEDPROS), Automated Time Attendance and Production System (ATAAPS), Defense Medical Human Resources System (DMHRSi). Knowledge of ICD-9, HCPC, CPT connections and guidelines Knowledge of Medicare and Medicaid payment rules
ADDITIONAL INFORMATION
Claims Adjudication software
Medical Manager, Word Perfect, MS Excel, MS Word, MS Access Record Management (filing) Medisoft for Windows
Use of peg board system to post charges, payments, and adjustments Ability to process and examine health claims(HCFA 1500, UB-92), for Medicare, Medicaid, and commercial
carriers. Billing for hospital; DME, Surgery, Anesthesia, Physicians services, Medicare and Medicaid billing.
Contact this candidate