Customer Service Operations Coordinator
Resume:
Beverly-Ann Stewart
Baltimore Md 21237
Cell Phone # 410-***-****
SUMMARY OF PROFESSIONAL SKILLS:
A seasoned healthcare professional with over 10 years combined front and back-end office, medical experience, customer service experience, billing experience at corporate office.
Strong experience in patient and facility collections.
Experience in pre-certification, insurance verification, appointment scheduling.
Strong liaison skills with physicians, patients, patient’s family members, insurance carriers, attorneys, staff members and pharmaceutical representatives.
PROFESSIONAL EXPERIENCE
ADVANCED RADIOLOGY
7253 Ambassador Road, Windsor Mill Md 21244. Phone # 443-***-****
REIMBURSEMENT OPERATIONS COORDINATOR CUSTOMER SERVICE
Sept 16th 2002- July 20th 2009
Answer all incoming calls in relating to patient bills
Verify insurance eligibility and filing limit as well
Make proper contractual obligations concerning patient billing when appropriate
Work bad address, H060 reports, return mail which had to be researched by using search engines to obtain better billing information
Take credit card payments over the phone as well as setting up budget plans for patients
Communicate effectively and efficiently maintain rapport with all customers.
Maintain composure and behaved professionally in dealing with customers in very difficult situations and know when to escalate any issues to a manager and or supervisor.
REIMBURSEMENT OPERATIONS COORDINATOR AR -FOLLOW-UP
Work with AR reports to identify problems on accounts, research and take the appropriate action to promote reimbursement.
Complete adjustments, check refund request forms and special transactions form.
Request additional information such as referrals, scripts, medical reports and contacting hospitals.
Follow up on actual denials and forward appeals when necessary to get claims reprocessed with correct billing information.
Also bill primary and secondary carriers for services provided and if there was a 3rd party which needed to be billed for services rendered and to collect on past due accounts which may have rolled to collections.
Collection team will be notified.
CHESAPEAKE UROLOGY
21 Crossroads Dr, Owings Mills Md Ph 410-***-****
PATIENT COLLECTION REPRESENTATIVE AND CUSTOMER SERVICE
July 22nd 2009 – October 1st 2012
Answer all incoming calls in relation to billing
Collect payments for patients who are self-pay with or without insurance
Set-up budget plans, processed hardship applications, processed credit card payments and posted the credit card payments, appointment reminders for patient balances. Also worked bad addresses and worked with search engines to obtain correct patient home address.
Work with precertification department regarding patient nop (notification of procedure)
Call patients and advise them on their upcoming estimated balance for the procedure.
PRECERTIFICATION BILLING REPRESENTATIVE
October 1st 2012 - Feb 18th 2014
Print out the precertification reports every morning
Precertification for 4 busy doctors
Call the insurance companies to verify eligibility, get authorization, obtain referrals from primary care physicians.
Call patients on any outstanding balances
Calculate the estimated balance for upcoming procedures based on the specific ins fee schedule.
Also check the balance from the self-pay fee schedule for the self-pay patients.
THE ROI COMPANIES
1920 Greenspring Drive, Timonium Md 21093 phone #877-***-****
May 2014- November 2015
COLLECTIONS REPRESENTATIVE
Worked off 2 systems, the hospital system and ROI’s system
Provided great customer service
Took incoming calls from patients and made outgoing calls
Answered any billing questions
Worked out of state hospitals – Cape Cod Hospital; Falmouth Hospital and worked from a queue in ROI’s system.
Provided patient’s report with outstanding balances
Called patients for payments on past and present balances on their accounts.
MOBILEX/TRIDENT USA
910 Ridgebrook Road, Sparks Maryland 21152 phone # 443-***-****
HOSPICE DEPARTMENT
November 2015 - May 2016
Worked for 90 days learning the computer system and how hospice departments works
Then moved to commercial department when my 90 days was up
COMMERCIAL DEPARTMENT
Commercial – Denials Specialist
May 2016 – Dec 20th 2016
When I was placed in the commercial department the supervisor created a report which showed the denials which are claims that were not paid.
I would call the insurance company to find out why they were denied and if we need to appeal and or send a corrected claim with attached documentation.
FACILITY COLLECTIONS
Dec 2016 to Jan 2019
Work off of 2 computer systems IDX and telcor
Ageing report showing account numbers, name of the facilities, $ amount which the facility owes
Read the notes to see what kind of follow up is needed.
Call the facility to find out if the payment was mailed out, if they received the invoices and when to expect payment in full.
Send out demand letters for the full payment when payment is past due
Send out a suspension letter when services are suspended
Have conference calls with the sales representative, collectors, director, manager which was just hired and the CFO.
REMEDI SENIORCARE
9006 Yellow Brick Road, Rosedale Md 21237 Phone 443-***-****
Jan 14th 2019 to present
PRIVATE PAY & FACILITY COLLECTIONS
I am the only one that works all facility collections. I work off 2 companies
I work aging reports which shows accounts numbers, name of the facilities and the amount the facility owes.
They would also the buckets i.e. 30 days, 60 days, 90days and 120day buckets – so will know what amounts are seriously past due and which ones we need to contact the facility.
I would also have to read the notes to find out what is the next step and what follow up needs to be done.
I worked all the facilities for all states: Md, Tampa, Dallas, Oklahoma, Virginia, Colorado, Cleveland, Detroit, Troy and Chicago.
I would process credit card payments. I would call the facilities to make them aware of what balances are outstanding and when we should expect payment.
I also escalated accounts if there were any disputes, questions and or concerns.
The Manager also runs agings for me to work
The team leader for the billing department sent out the invoices to the email address they have on their system.
I also follow up with and any facility to make sure that those emails are current.
PROFESSIONAL AFFILIATIONS
Successfully completed six module courses for customer service
Name of the course was “THROUGH THE CUSTOMER’S EYES”
Upon completion of the six-module course one was awarded a certificate which was issued April 22,208
EDUCATION
Tranquillity Government Secondary College -5 years in Trinidad & Tobago….1981-1986 August
Sarah’s Secretarial College 6 months graduated
TESST ELECTRONICS AND COMPUTER INSTITUTE IN COLLEGE PARK MD -6 MNTHS. GRADUATED. 4.0 AVERAGE
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