Customer Service Data Entry
Resume:
Clemencia Hart
AR Insurance Specialist
Jonesboro, GA 30238
*********@*****.***
SKILLS
Knowledgeable in computer operations, applications, and operating systems such as: Metavance, Microsoft Office, Citrix, Availity, Navinet, EPIC, IDX and National Provider File. HIPAA trained. Can type 60 wpm.
EXPERIENCE
Med-Medtrix, Atlanta, GA - Account Receivables
March 2021 - Present
●Research and respond to billing questions and inquiries
●Negotiates payment on patient account balances
●Retain thorough understanding of insurance, registration, scheduling, referrals, authorizations and account follow-up to secure reimbursement of claims.
●Rebilling to primary or secondary insurance
●Coding claims to submit to insurance for processing
●Review and research claims for denial reasons.
●Prepare and file appeals timely.
●Complete request for reconsideration forms following payor requirements and submit submit within timely filing periods.
Emory Hospital, Atlanta, GA - AR Insurance Specialist
August 2018 - March 2021
●Research and respond to billing questions and inquiries
●Negotiates payment on patient account balances
●Retain thorough understanding of insurance, registration, scheduling, referrals, authorizations and account follow-up to secure reimbursement of claims.
●Rebilling to primary or secondary insurance
●Coding claims to submit to insurance for processing
●Review and research claims for denial reasons.
●Prepare and file appeals timely.
●Complete request for reconsideration forms following payor requirements and submit submit within timely filing periods.
Anthem Blue Cross Blue Shield, Buckhead, GA - Customer Service/Claims
May 2018 - August 2018
●Answering inbound calls and making outbound calls in a high volume call center
●Respond to complex telephone, electronic, and written inquiries from healthcare members
●Sending confirmation faxes to the doctor’s office
●Data Entry
●Processed claims for payment
Maximus, Atlanta, GA - Customer Service
Nov 2017 - May 2018
●Answering inbound calls in a high volume call center
●Respond to complex telephone, electronic, and written inquiries from state healthcare members, groups, and members
●Data Entry
Delta Dental Insurance Company, Alpharetta, GA - Customer Service/Provider Admin Specialist
FEB 2012 - AUG 2017
●Answering inbound calls in a high volume call center
●Member of the escalation team
●Respond to complex telephone, electronic, and written inquiries from dental professionals, groups, and members
●Trained and development for new hires (SME)
●Coordinated with other departments to ensure provider information is current
●Claim processing
●Data Entry
●Up-selling
●Process insurance/member correspondence
●Research delinquent claims to identify payer and/ or claim office trends, resubmit missing claims, report findings to my supervisor.
Dept of Revenue/State of GA, Atlanta, GA - Customer Care Specialist
OCT 2011 - FEB 2012
●Mastered the art of providing superior customer service in a high volume call center
●Resolves issues with taxpayers
●Assisted taxpayers with liens, garnishments, amended returns
●Data Entry
NCR, Peachtree City, GA - Customer Care Specialist
APR 2007 - NOV 2010
●Mastered the art of providing superior customer service to technicians with part orders and UPS tracking
●Assisted technicians with part orders
●Up-selling
●Parts look-up
EDUCATION
University of Phoenix, Phoenix, AZ - Associate of Arts with a Concentration in Business Fundamentals
SEP 2017 - Current Student
Current GPA: 4.00
VOLUNTEER EXPERIENCE OR LEADERSHIP
Well-organized, goal oriented insurance professional with experience in team building, customer service, and staff development. Escalation resolution, coaching and quality assessments
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