Customer Service Data Entry
Resume:
Kimberly
Ann
Miller
Experience
Skills
Education
Customer Service-Oriented
Data Entry and Database
Skilled Collaborator
HIPAA Compliance
Payments Posting
Eligibility Determination
Claim Amount Calculations
Coverage Determination
Insurance Claim Forms Review
Reimbursements
Insurance Verification
Prior Authorizations
Insurance Verification
Medical Billing & Coding
Claims Examination
Zendesk
EPIC
ICD-10, ICD-9, CTP Codes, HCPCS
Capitalization Support
Payment Posting
Claims Processing
Records Coordination
Collecting Payments
Claims Investigations
Authorize Payments
Benefits Review
Live Chat Messaging
Provider Credentialing
Insurance Policies
Electronic Health Records
Administrative & Clerical Support
Email Support
Medical Terminology
Team Management
Appointment Scheduling
EMR, OTTR (transplant scheduling
software) Maestro, Genesys,
Fast Track, Meditech 6.0 E-Clinical
(ECW)
AMAP-NYS (Medication
Administration)
Bronx, NY 10469
ad4uj4@r.postjobfree.com
Associates of Applied Sciences 2011
College of New Rochelle
High School Diploma 2002
William Howard Taft High School
Summary
Passionate healthcare professional with extensive experience. Proficient in using independent decision-making skills an sound judgment to positively impact company success. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses.
Providing support to members via phone, email, or online chat, addressing inquiries about their health insurance plans, benefits, coverage, claims, and general queries. Assisting members in resolving problems, such as claim disputes, coverage issues, or understanding policy details, ensuring a positive customer experience. Educating and guiding members on available health plans, benefits, network providers, and services offered by UnitedHealth Group.
Recording and maintaining accurate records of customer interactions, inquiries, and resolutions using customer service software or databases. Ensuring compliance with company policies, privacy regulations, and guidelines while handling sensitive member information.
UNITED HEALTH GROUP - REMOTE
MEMBER SERVICE REPERESENTATIVE 10/2016 - 04/2023
Welcome and register patients, handling co-payments and gathering insurance details. Aid Liver/Kidney nurse coordinators by transmitting patient records to collaborating healthcare facilities.
Maintain updated insurance and patient particulars in the E-Clinical scheduling system. Acquire authorizations from insurance providers for procedures and diagnostic tests. Arrange, rearrange, and confirm patient appointments with healthcare professionals. Manage 100-300 inbound and outbound communications with patients and providers for upcoming and follow-up appointments.
Utilize EMR software for organizing patient records while ensuring strict adherence to patient confidentiality as mandated by HIPAA and clinic regulations. WESTCHESTER MEDICAL CENTER - VALHALLA, NY
UNIT CLERK LIVER/KIDNEY TRANSPLANT CENTER 08/2015 - 10/2016 Collaborated closely with Doctors, Nurse Care Managers, and Social workers to facilitate patient aftercare post-discharge, specifically concerning durable medical equipment. Handled resolution of complaints from payers, providers, and patients, ensuring effective management of non-clinical information and escalating issues when necessary. Maintained compliance with HIPAA guidelines and ensured efficient processing of paperwork in a timely manner to support smooth transactions. Possessed knowledge of CPT, ICD 9/10, and procedural modifiers. LANDAUER MEDSTAR (ADAPT HEALTH) - REMOTE
CUSTOMER SERVICE REP/INSURANCE VERIFICATION 07/2013 - 04/2015 Carried out clerical and receptionist responsibilities within the ICU unit, providing support to patients and their families by welcoming and aiding them. Managed inventory and supplies, handling over 500 incoming phone calls and organizing appointments.
Retrieved essential documents and managed intake applications. Conducted insurance verification and obtained prior authorizations as necessary. Arranged radiology appointments, including scheduling mammograms, ultrasounds, MRIs, and CT scans.
ST. JOHN’S RIVERSIDE HOSPITAL - YONKERS, NY
UNIT SECRETARY/INTENSIVE CARE UNIT 2005 - 2013
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