Customer Service Representative

MARTHA EDWARD

Grand Rapids, MI ***** 616-***-**** ******.********@*****.*** Martha Edward - Customer Service Representative - WestRock Company LinkedIn

PROFESSIONAL SUMMARY

Detail-oriented and meticulous Medical Insurance Billing Specialist with extensive experience in insurance claims management, coding, and patient account analysis. Adept at ICD-10 and CPT coding, with a proven track record of reducing claims denials and enhancing revenue retrieval. Committed to upholding the highest standards of compliance and confidentiality.

CORE COMPETENCIES

ICD-10 & CPT Coding

Claims Adjustment & Reconciliation

Insurance Verification & Authorization

Patient Account Analysis

Medical Terminology Proficiency

Meticulous Documentation

Compliance & HIPAA Regulations

Outstanding Customer Service

Proficient in Claim Gear & Electronic Billing Systems

Expertise in Microsoft Office Suite & 10-Key

PROFESSIONAL EXPERIENCE

Assistance Team Counselor Independent Bank – Grand Rapids, MI (09/2018 to 01/2023)

Pre-screened resumes prior to sending them to corporate hiring managers for consideration, enhancing recruitment efficiency.

Collected and analyzed information to monitor compliance outcomes, identifying trends of non-compliant behavior and implementing corrective measures.

Reduced expenses by analyzing compensation policies and implementing competitive programs, ensuring adherence to legal requirements.

Coordinated the implementation of people-related services, improving employee satisfaction and operational efficiency.

Managed over fifty customer calls per day, exemplifying strong critical thinking skills and customer service.

Customer Service Representative Axelon Services Corporation (Contract) – Grand Rapids, MI (12/2024 to 02/2024)

Received and processed routine customer orders, inquiries, and complaints, ensuring an elevated level of service and customer satisfaction.

Maintained ongoing relationships with customers and sales staff, providing a reliable communication link.

Customer Service Representative Fifth Third Bank – Grand Rapids, MI (01/2023 to 06/2023)

Assisted a large volume of customers daily, maintaining a cheerful outlook and a focus on customer satisfaction.

Adhered to company policies and scripts to meet call-time and quality standards, documented interactions in CRM databases.

Medical Billing and Collection Specialist Robert Half Finance and Accounting – Grand Rapids, MI (03/2015 – 05/2015)

Managed accounts receivable and coordinated with insurance companies, Medicare, and Medicaid to expedite claim processing.

Maintained elevated levels of customer service during collection calls, ensuring professionalism.

Medical Billing Specialist Activa Benefit – Grand Rapids, MI (12/2013 – 03/2014)

Resolved denied claims and consulted with insurance providers, improving claims resolution efficiency.

Conducted patient billing and payment issue resolution, enhancing patient satisfaction and trust.

EDUCATION

Associate of Science: Human Resource Management (Expected in 05/2024)

oCornerstone University – Grand Rapids, MI

Diploma: Medical Insurance Billing and Coding (06/2014)

oEverest Institute – Grand Rapids, MI

CERTIFICATIONS

Certified Professional Coder (CPC) [If applicable]

Certified Medical Reimbursement Specialist (CMRS) [If applicable]

TECHNICAL SKILLS

Major medical billing software systems

Databases: CRM Systems, MS Access

Office Suite: Microsoft Word, Excel, PowerPoint

ACHIEVEMENTS

Improved claim processing accuracy by 20% through meticulous coding and compliance checks.

Decreased average claim denial rate by 15% by implementing proactive verification protocols.

PROFESSIONAL DEVELOPMENT

Continuous education in medical billing and coding updates, including seminars and online courses.

Regular participation in workshops on healthcare compliance and ethics.

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