JOEL MILLER

**** ****** **** **** ******, TX ****3 469-***-**** ad31m8@r.postjobfree.com

PROFESSIONAL PROFILE

Customer service oriented professional able to coordinate the medical office administrative and clerical duties to ensure effective patient services and optimal levels of patient volume and flow. Backed by 6+ years combined healthcare industry and management experience. Follows policies, procedures, and guidelines to ensure consistent quality.

Serve as liaison between physician, patient, and insurance carriers

Strong verbal, written and interpersonal communication skills

Function independently with minimal direction and guidance

Fluent in American Sign Language (ASL)

Microsoft Office Applications / MS Excel MS Word MS PowerPoint MS Outlook MS Teams Typing Speed: 38 WPM

Communication Platforms: Zoom Skype

Electronic Medical Records (EMR / EHR) ScriptMed Tri-paine Availity Emdeon

KEY QUALIFICATIONS

Medical Administrative Assistant Medical Terminology Medical Transcription Patient Processing

Patient Registration Medical Records Management Check In Check Out Data Entry Release of Information

HIPAA Compliance Medical Laws & Ethics CMS 1500 Claim Form Billing Cycle Claims Appeal Process

Medical Billing Knowledge Third Party Billing Medicare Medicaid HMO PPO

Basic Coding Skills for ICD-10 & CPT Insurance Verification Anatomy & Physiology

EDUCATION

David W Carter High School Diploma, 2002

PROFESSIONAL EXPERIENCE

AllianceRx Walgreens Specialty Pharmacy Dallas, TX 11/2017 – Present

Remote Insurance Verification Specialist/ Case Manager

Manage Rx and Medical claims processes

Provide benefit investigation for in and out of network coverage for Medicaid, Medicare, and Commercial Insurance

Perform inbound and outbound calls regarding to claims and policies, while operating multiple computer applications

Respond to inquiries from policy holders, physician, member service and scheduling department

Independently process pre-determinations, pre-certifications, authorizations, and appeal approvals

Handle grievances or escalation appeals ranging from routine to administrations, high copay, and benefit break down

Contact patients in regard to financial responsibilities and utilize ScriptMed, Tri-paine, Availity, and Emdeon Software

Contribute towards the center's achievement of providing exceptional customer service by demonstrating stamina, to successfully complete customer calls within established work hour

Submit Pharmacy PDM (Part D insurance) claims for specialty injectable medications

Willis Towers Watson Richardson, TX 06/2014 – 02/2017

Application Data Processor

Verified health insurance and educated customers on benefit plans and coverages

Interfaced with customers via inbound phone calls and documented interactions

Enrolled patients and members into individual health insurance plans based on their needs

Entered information, scheduled appointments, and demonstrated mastery of customer script within specified time frames

Provided accurate and appropriate information in response to customers inquiries

Addressed customers service inquiries in a timely manner and accurate fashion

Read questionnaires to customers to see if they qualified for specialty programs and processed payments

J'Dramatic Cleaning Services Garland, TX 03/2013 – 06/2014

Receptionist

Greeted patrons, answered inbound phone calls, provided information, and scheduled appointments

Maintained office supplies, performed basic filing duties, and send email and faxes

Oversaw light cleaning duties, assisted with invoices as needed, processed payments, and updated client information

Crystals Carwash Garland, TX 01/2012 – 03/2013

Assistant Manager

Trained new hires, maintained daily records of all transactions, and generated reports for manager

Ordered supplies for office and workers, submitted audit payroll for processing, and prepared bank deposits

Accepted and processed payments, handled customer complaints, counted tills, and completed paperwork

Completed work orders for broken machinery via outbound phone calls

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