Customer Service Patient Care
Resume:
Rebecca Phillips
Saint Petersburg, FL *****
*********************@***********.***
Highly skilled, compassionate, empathic and solution oriented health professional, dedicated to
providing exceptional care and implementing effective treatment plans for children, adolescents
and adults. Expertise in processing and adjudicating claims and working with cross-functional
claims departments including medical claims review, contracting, and fraud. Effective motivator,
communicator and advocate with inherent ability to manage all personalities, diffuse stressful
situations, proactively resolve issues, meet and achieve challenging goals and objectives. Superior
leadership skills proven in successful staff development and group facilitation. Proven ability to build
positive relationships with patients, family members, physicians and other medical professionals.
Proficient in all documentation/record maintenance/paperwork to ensure accuracy and patient
confidentiality.
● Thorough physical assessment skills, with in-depth knowledge of patient registration process
● Remain calm under pressure; and strengths in making swift, correct decisions in emergency
situations.
● Able to work a variety of hours, including nights, weekends, and holidays
● Effective leadership, communication, management and organizational skills
● Remarkable experience in reviewing and making determinations regarding insurance claims
● Ability to analyze claims, set reserves, determine compensability and settle claims
● Ability to maintain records, prepare reports and conduct correspondence related to the work
● Dеmоnѕtrаtеd ѕоlid аnаlуtiсаl, diаgnоѕtiс, needs-assessment, рriоritizаtiоn, dесiѕiоn-mаking, аnd
multitasking skills.
● Professional team player with strong work ethic, communication skills, and attention to detail.
● Experience with multitasking and meeting deadlines in timely manner.
CORE COMPENCIES
● Case Management • Health outreach • Clinical Judgment
● Medication Administration • Parent/ Patient • Family Education
● Data Entry/Administration • Crisis Intervention • Client Assessment/Evaluation
● Admissions • Medical charting • Triage phone calls
● Customer Service • Billing and Collection • Patient care management
● Inventory Management • Injection Administration • Trials pain management.
● Insurance Evaluation • Claims Administration • Reports and Record Analysis
Willing to relocate: Anywhere
Authorized to work in the US for any employer
Work Experience
Senior Customer Service Specialist
Capital One - Tampa, FL
March 2016 to May 2019
Responsible for primarily fielding inbound calls, answering questions, providing an unmatched
customer experience, and handling customer concerns through one call resolution. Associates will also
utilize a variety of systems and tools to efficiently service the needs of the customer and will inform
and educate customers to help them make well-informed decisions essential to utilizing their credit
card in this ever growing digital world. In addition, listening skills are critical such that effective use of
information that is “heard” is fully leveraged.
Patient Care Coordinator
Speak easy - Tampa, FL
May 2012 to 2016
Speak Easy translation and transportation
● Provide oral and written interpretation of legal documents or proceedings.
● Verify information from original text in order to ensure appropriate interpreting
● Ensure that all written translations conform to the original text in terms of technicality and
terminology
● Submit translations for acceptance by any court or government agency in the United States or
abroad.
● Ensure that both content and style of statements in communicated effectively
Patient Care Coordinator
PMSI HOLDINGS
2012 to 2015
Processed/fulfilled product therapies and services to Injured Workers within the Critical Care division.
● Assisted physical therapists as needed and maintained cleanliness of facility
● Utilized a windows based operating system to generate purchase orders, provisioned by PMSI
Network of Contracted and non-Contracted Providers.
● Follow up on all orders, price quotes, special authorizations, Letters of Medical Necessity and
other DME referral workflow to PMSI Clients which include Adjusters, Nurse Case Managers, Patients,
Physicians, Vendor Providers and other referral sources.
● Collaborate with Supervisor and others to manage queues to meet appropriate weekly and monthly
order completion volume, order aging and authorization metrics.
● Communicated with other doctor offices, imaging offices, and all other organizations as needed
Medicare / Medicaid Operations Specialist
HUMANA
2006 to 2009
Served as primary resource to 3,800 individual and corporate member accounts on various benefit
issues including individual health plans and state and federal laws/mandates
● Provided client-specific advice, counseling and representation on matters involving insurance issues,
public/private benefits and other legal issues to Medicare beneficiaries and/or their caregivers
● Assisted potentially eligible Medicare beneficiaries and/or their caregivers to apply for entitlement
programs and ensured that benefits were understood by applicants
● Handled billing, enrollment, claims, and authorizations
● Maintained and established indispensable relationships with sales professionals to enroll new
members and maintain existing memberships.
● Addressed and resolved customer issues, ensuring total member satisfaction.
● Coordinated monthly team meetings and served as the primary contact person and leader for
special team-building events and activities
Achievements
● Implemented new Web Enrollment Department within Humana and provided backup support to
other departments.
● Received numerous service awards and monetary bonuses for quality and outstanding performance
● Recognized as a trustworthy and dependable employee; received many perfect attendance awards
Customer Service Representative
Verizon and GEMB
2000 to 2006
Greeted customers in person and over the telephone
● Inquired into customers' purpose of visit or call
● Listened intently to understand query or problem
● Provided customers with information on products and services provided by the company
● Demonstrated product features and answer questions regarding price, features and aftersales
services
● Took customers' orders and provide them with delivery options
● Assisted customers through the payment procedures and ensure proper packing of purchased
products
● Take and record customers' contact information in company database
● Provide customers with information on aftersales services and warrantees
● Handle product recalls, returns and replacements
● Increased company revenues by maximizing opportunities to sell additional products and services.
LICENCE
● Florida 240 Health Insurance License
● Voluntarily received 240 License on personal time to better serve Humana and generate additional
sales
Education
Some college
Skills
• Microsoft office suite (10+ years)
• Call center (10+ years)
• Billing
• Data Entry
• Microsoft Excel
• Microsoft Word
• Organizational Skills
• Outlook
• Receptionist
• Scheduling
• Microsoft Office
• training
• CPR
• Microsoft Office
• Epic
Contact this candidate