Customer Service Medical Office
Resume:
Shantele Douglas
Laurinburg, NC ***** 910-***-**** *****************@*****.***
PROFESSIONAL PROFILE
Customer service oriented professional, capable of providing timely and accurate data to ensure reimbursement for patient services. Follows policies, procedures, and guidelines to ensure consistent quality. Maintains and safeguards patient privacy and confidentiality.
Well-organized, manages time and priorities in multi-task environments
Effective problem solver, able to assess situation and identify solutions
Work as part of a team and maintain a professional and positive environment
Microsoft Office Applications / MS Word MS PowerPoint Typing Speed: 30 WPM
KEY QUALIFICATIONS
Medical Practice Management Systems Medical Terminology Medical Records HIPAA Compliance
Insurance Verification Insurance Claim Processing Reimbursement Processing Revenue Cycle Management
Medicare / Medicaid Government Payers Third Party Payers CPT & ICD-10 Coding
Medical Billing Medical Office Medical Administrative Patient Registration Data Entry
EDUCATION
Ultimate Medical Academy Diploma – Medical Office and Billing Specialist, 2021
Ultimate Medical Academy HIPAA Essentials for Healthcare Professionals Certificate
PROFESSIONAL EXPERIENCE
Scotland Surgical & GI/Wound & Cancer Center – Laurinburg, NC 09/2022 – Present
Patient Registration (PRN)
Handled inbound and outbound telephone calls
Adhere to HIPAA law and Scotland Surgical & GI
Perform registration services for the Wound and Cancer Division
EPIC EMR Software: verify patients’ demographics, confirm the insurance eligibility and healthcare plan status
Citrix EMR Software: utilize the electronic medical system to log in and enter the hospital internal sites
Billing: process patients healthcare bill and co-payments. Accept cash, credit/debit cards, and checks to satisfy the out-of-pocket expenses, and at the request of the patient mail out the invoices
Check in/out, scheduling and discharges of patient’s appointments and release from the hospital
Scheduling: receive the settings to setup the patients’ appointments from the clinical team and apply the patient’s availability for the next medical treatment, doctor visits, and examinations. Send out medical reminders to patients via standard United States Postal mail and email concerning physician medical appointments.
Medical Screener: screen all incoming visitors, clinical staff, vendors, and guest for COVID-19. Update the daily log and reports in accordance with the hospitals SOP requirements.
Sitel/United Healthcare Group – Nashville, TN 03/2022 – 06/2022
Customer Service Representative (REMOTE)
Handle inbound and outbound telephone calls
Adhered to HIPAA law and United Healthcare Group policies
Process Medicaid/Medicare and Standard Healthcare Insurance
NC Track Medical Management System: verify the patients’ demographics, insurance, process payments and billing
Insurance verification: review and confirm the insurance coverage and eligibility
Process medical claims, prior authorizations, referrals and appeals
Reviewed CPT codes/ICD-10 to ensure proper billing of the medical claim
Billing: review the claim, and accepted payments, and reimbursement. Accepted credit and debit cards and mail out bills to patients
Wendy’s – Laurinburg, NC 08/2011 – 03/2022
Crew Member/ Cashier / Customer Service
Perform opening and closing duties, answer inbound phone calls, and train new hires
Process payments, operate cash register, and accept payments
Cook and prepare batches of food, prepare deposits, and count tills
Make outbound phone calls and assist with interview process
It's Fashion Metro – Laurinburg, NC 02/2015 – 10/2019
Floor Manager / Customer Service
Completed opening and closing duties, supervised 6 employees, and trained new hires
Collected payments, handled light cleaning duties, and operated cash register
Prepared bank deposits, maintained inventory levels, and handled inbound and outbound phone calls
Maintained displays, processed layaway orders, and upsold products
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