Support Specialist Customer Service

Alicia Melton,

Lead Administrator / Customer Service Specialist

***** ******* ***** **., ********, Texas 77339

**********@***.***

(Mobile) 281-***-****

PROFILE Highly skilled office administrator with at least a 16-year track record, with administrative work, and highly productive office management skill sets. Proactive and reliable, with a meticulous sense to detail, and organized in nature. Strong communicator that allows to communicate well with all staff members. Which then allows to have a thriving and supportive environment leading to a positive practice growth.

EMPLOYMENT HISTORY

March 2007 — Dec 31, 2023 Office Lead Administrator/ (Gastroenterology) (Pain Management)

Gastroenterologist – Dr Garland Gossett / Pain Management – Dr Kimberly Henderson

Advance Administrator and analytical skills in overseeing day to day operational for credentialing

HR responsibilities – interviews, managed, trained staff members, established and monitored goals and performance reviews.

Responsible for processing applications and reappointments for all locations.

Managed all Physicians Credentialing up to date thru various system, including all pay or contacts

Maintained office operations and procedures, processed Biweekly Payroll/ and controlling correspondence statement, medical records. Overseeing daily Billing department functions, including medical coding, charge entry, payment posting and reimbursement. Mailed out statements, coordinate patients payment plans, including verifying insurance policy benefit information, obtaining Authorization/ Precertification prior to the patient's visit or scheduled

Manage collections through third party reimbursement procedures manage denial reports payor websites.

Managed office polices and audits. Resolved billing issues identified by insurance carriers and patients. Reviewed claim denials and payer requirements for corrective action and prevention.

Managed office services by organizing office operations and procedures. Managed agendas, travel arrangements, appointments, phone calls, and correspondences. Coordinated office activities and operations. Achieved high efficiency which lead to adhering to the company polices. Proficient in Medical EMR (Eclinical Works, Athena Health, EMA)

March 2003 — July 2004 Office Administrative II, University Care Plus (UT Orthopedics)

Provided accurate and appropriate information in response to patient’s inquiries. Coordinated patient volume statics report. Worked with upper management to ensure changes for customer satisfaction.

Developed effective relationships with all call center departments through clear communication. Monitored billing reports and corrected all errors that saved money for the practice. Verification for all insurance contracts including the providers in the practice.

Worked with upper management to ensure appropriate changes were made to improve customer satisfaction. Trained staff on how to improve customer interactions. Identified and addressed roadblocks for the team to progress and succeed. Resulting in a smoother flow of work and improved team morale.

May 1997 — March 2003 Insurance Referral Coordinator, Hermann Hospital (Center for Pain Management)

Obtained detailed medical and personal data for patient charts and records.

Maintained organized records of customer prescriptions, work orders and office payments.

Verified insurance coverage and entered patient information and billing codes into the system.

Utilized the computer system/EHR according to departmental protocols to include accurate data entry and retrieval of information for reporting purposes.

Maintained close communications with key insurance companies. To ensure that referrals and prior authorizations are completed and followed up per requirements.

EDUCATION

2002 — 2002 Certified Medical Coder (CMC) Houston

2022 — present Houston Community College Houston

1991 — 1995 Evan E. Worthing High School Houston

SKILLS Ability to Work under Pressure Adaptability/Leadership

Microsoft Office Programs Communication Skills

Lathem Pay Clock Calender Management

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