Jamale C. Moore

**** **** **** ***** ********, GA 31907 ad336n@r.postjobfree.com 706-***-****

Professional Summary

An energetic and highly experienced Medical Assisting professional/collections with over a decade of successful experience in customer service, health care and management. Committed to patient comfort, care, eligibly and satisfaction.

Qualification Highlights

Leadership experience

Eligibility/claims

Computer and software

Proficiency and Sales

Ability to learn

Positive personality

Records management/Logging inventory

Dynamics & DPI Software

Familiarity with medical terminology

Problem-solving abilities

Strong communication skills

Computer

technology

Organizational know-how

Eager and willing to learn

Attentive listening, empathy

Teamwork/Teams chat

Technological skills

Collections/bill payments

Data entry/Documentation data entry

Health Care capabilities

Health care Benefits

Send out Macros

AS400Ib MI

Avaya One x

Face Mask Cushions

CT Desktop

Olli/ Trifecta

Thin client/HP

CPAP Equipment

OnBase/Echo’s

Vo fl. agent desktop

Stale orders

Water Chambers

Outlook system

Mainframe

Dream station system

Send out Macros

Pap compliance

Confirming insurances

Adding & deadlines of insurance

Good customer service

Sending out emails to management confirming delay’s /letter writing

Education

Miller-Motte Technical College Columbus, GA 2013- 2015

Associate of Occupational Science Degree – Medical Assisting

Professional Experience

Health care claims/customer service Rep 1

Jacobson and Jacobson -WPS 2022-2023

Tricare East offers Special Programs for certain health conditions, populations, or concerns.

• Have specific eligibility requirements based on your plan, beneficiary category, or status.

• Are for specific beneficiary populations while others offer services for specific health conditions to give EOB, process, reprocess, give status, recouping, letter writing and faxing the amounts to adjustments of the claims for the vendors.

• Are limited to a certain number of participants or to a certain geographic location.

• Help providers submit claims and find out why the claims are denied and reprocess them.

• If you're experienced and meet the appropriate certification requirements in your field, we need your expertise, also help the provider get re- certified with their contract with Tricare East.

• We deal with the provider and the Patients when it comes to the EOB’s and the bills. The patients call to make she the cost share/copay or deductible is correct or why they must pay one.

• Claims Processing and Reporting Regardless of who submits the claim, SHCP claims shall be processed using the same standards and requirements in Chapters, unless otherwise stated in this chapter. The contractor for the region in which the patient is enrolled in a certain program. Also adj the claims if need, recoupment and reimbursement when it comes to overpayment either to the provider of patient is also provider with the position.

Claims/customer service

Humana Military Healthcare 2023-2023

Tricare offers Special Programs for certain health conditions, populations, or concerns.

Some Special Programs:

• Have specific eligibility requirements based on your plan, beneficiary category, or status.

• Are for specific beneficiary populations while others offer services for specific health conditions to give EOB, process, reprocess, give status, recouping, letter writing and faxing the amounts to adjustments of the claims for the vendors.

• Are limited to a certain number of participants or to a certain geographic location.

• As a civilian employee you'll get excellent work-life benefits to include competitive salaries, and health and life insurance. Many jobs also include flexible work schedules.

• If you're experienced and meet the appropriate certification requirements in your field, we need your expertise. Entry-level jobs are also available for select positions across the United States.

• The Army, Navy, and Air Force have received expedited hiring authority to shorten the often-long government hiring process for certain critical health positions.

• Claims Processing And Reporting Regardless of who submits the claim, SHCP claims shall be processed using the same standards and requirements in Chapters, unless otherwise stated in this chapter. The contractor for the region in which the patient is enrolled in a certain program.

Data Entry/Inventory/Packing inspector

First Lane Logistics 2022-2023

• Receiving and shipping packages you deal with the following shipping carriers: UPS, FedEx, USPS, DHL, Laser Ship and OnTrack. Manages the shipment and receipt of all products, materials, and supplies.

• Collaborates and communicates with logistics technicians, customer service representatives, service providers, and others involved in the shipment and receipt of products.

• Tracks, traces, and update with documentation, data entry of the status of incoming and outgoing shipments.

• Maintains a clean, neat, and member-ready area.

• Promptly unloads trucks and deliveries and sorts and stocks receivables.

• Maintains an accurate log sheet of daily moves, scanning inventory, and counting accurately.

• Engages with vendors and drivers with a positive attitude.

• Provides additional backup support for shipping and receiving departments.

• work for an organization that rewards success and fosters a culture of promotion. Healthcare Customer service Representative

Costumer service

Lin care Holding 2022-2022

• work directly with medical Supplies to facilitate patient care.

• advocate for and work in lockstep with chronic patients12

• work for an organization that rewards success and fosters a culture of promotion.

• provide outcome-based solutions for our referral sources and existing patient population.

• Submit new orders and monitor their completion, from initiation to setup, working closely with the LLC, sales, and service departments.

• Work closely with existing patients to troubleshoot issues, identify solutions, and dispatch corrective action via the appropriate departments within the organization.

Healthcare/customer service/sales insurance Medicare

IES/Health IQ 2020-2022

• Recommend potential products or services to management by collecting patient information and analyzing customer needs Health IQ is the only Medicare broker that uses your detailed health record and our AI platform to find a plan truly tailored to your needs.

• Sales representative agents are often the first contact with our clients.

• Outbound dialing to our senior clients and transferring to licensed Medicare sales agents.

• Asking and recording pre-qualifying questions

• Use sales and communication skills to engage and educate clients.

• Building rapport through authentic conversations

• Using our proprietary tools to record information and assist clients in improving their coverage.

• Following our sales scripts and best practices

• Maintaining compliance standards/HIPPA

• Consistently achieving Call, transfer, sale and talk time targets.

• Learning and then applying sales / communication techniques and basic Medicare knowledge from the training we will provide.

Customer service Representative/Health care

Ttec Temp Remote WellCare Phoenix, AZ

Work From home/online 2017-2022

• Signing up customers with mail order for their medication, phone inbound and outbound service, collecting vital information such as address, residential and Personal accounts.

• Prepared rooms for tech, chat team lead, transfer and supervisor Assistance if needed for the call, keeping information confidential and confirming varication of each account for security purposes.

• Performed general health information for the patients, such as answering telephones, taking dictation, or completing prescription orders, and making sure the medication goes through and why it would not get approved performing Test claims.

• global leader in providing customer service, technical support, and supplemental sales on behalf of our clients’ brands, for their valued customers.

• Analytics – Sales and service, Understanding the customer experience, improving efficiency, effectiveness, and sales.

• Showing empathy, concern on behalf of the member and making sure they receive the correct medication, and everything is up to date in the system for the member also.

• Flexible and adaptable to change with excellent time management and web support.

• Providing benefits of coverage, claims and eligibility of insurance to the members to making sure they can use the insurance once they had a doctor’s appointment.

• Managing the ability to print out their ID card of insurance and to help web site assess also to give to the Doctor office and the pharmacy of coverage also.

Road America Columbus, GA

Operations Team Lead

2006 - 2016

• Manage the response center ensuring over 200 Assistance Coordinators are effectively handling workload.

• Monitor direct reports’ service levels to ensure compliance with client expectations.

• Monitor employee attendance, breaks, and schedules to ensure service levels will be met.

• Prepare daily, week, and monthly productivity reports to provide to management team.

• Dispatch out roadside assistance to customer who have broken down on the side of the road.

• Did supervisory phone calls to upset customers and was able to resolve their issue with one call resolution.

• Outstanding customer service skills, including a pleasant, professional telephone manner.

• Self-motivator with strong problem-solving skills

My Care Urgent Care Columbus, GA

Medical Assisting Practicum Spring 2013-2015 Quarter

• Recorded patients' medical history, vital statistics, or information such as test results in medical records.

• Prepared treatment rooms for patient examinations, keeping the rooms neat and clean.

• Performed general office duties, such as answering telephones, taking dictation, or completing insurance forms.

• Operated x-ray, electrocardiogram (EKG), or other equipment to administer routine diagnostic tests.

• Performed routine laboratory tests and sample analyses.

• Explain procedures and discuss test results and prescribed treatments with patients.

• Notate findings and treatment course in patient electronic chart including follow-up notes. participates in and monitors patient and family care compliance activities Obtains and accurately documents patient vital signs, height and weight, takes brief history on current illness or injury, current medications, allergies, required screenings, and other pertinent information as appropriate.

• Reviews/Documents Social Determinants. Provides education/resources as needed.

• Maintains equipment and medical supplies, including reordering, stocking, cleaning/disinfection per protocol, and troubleshooting. Maintains examination areas.

• Performs basic diagnostic procedures and specimen collection, including phlebotomy, splint application and procedural tray/room set-up.

• Monitors and communicates changes in patient condition. Documents patient care provided. Provides discharge instructions and follows-up with patient as needed. Recognizes and seeks help in emergent situations.

• Manages and facilitates all in-basket messages and patient phone calls.

• Activates of My Chart Accounts where appropriate. Ensures Telehealth connectivity for scheduled appointments and trouble shoots as needed.

• Reviews patient charts to ensure imaging is available and all pertinent information to maximize appointment.

• Round with patients in practice to ensure Excellent Patient Experience is met.

• Performs administrative or clerical duties as assigned, including scanning, reception, scheduling, data entry, and patient registration.

• Follow-up on reported issues and assists with service recovery.

Certifications

American Heart Association Basic Lifesaver for Healthcare Providers (CPR and AED)

American Heart Association Heart Saver First Aid

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