Customer Service Call Center
Resume:
CAMILLE A. BIZRI
************@*****.***
SKILLS SUMMARY
• Medical Authorization
• Claims Processing, Resolution
• Strong Interpersonal Skills
• Eligibility Verification
• Call Center, Customer Service
• HIPAA Trained
• Medical Billing, Collections
• Troubleshooting, Issue Resolution
• Software: AOD, DMAS, EVS, MMIS, Emdeon, Meditech,
EMPLOYMENT HISTORY
Healthcare Consultant/Contractor, Rockville, MD Nov 2016 – Feb 2018
Medical Claims Specialist/Patient Authorization Specialist
• Managed the patient insurance authorization process for requested services.
• Provided timely updates to clinical team on outcome of authorization process.
• Advised clinical team on changes in insurance reimbursement practices related to authorization process.
• Educated, counseled patients on insurance coverage; explained available payment options.
• Determined claims eligibility; investigated, processed, and adjusted patient claims.
• Worked from the ATB (Accounts Trial Balance), 30/60/90 days to identify problems in revenue cycle, brought resolution to increase cash flow.
The Virginian Retirement Facility, Fairfax, VA Nov 2013 – Aug 2015
Medical Biller/Cashier/Collector
• Entered patient demographic, pay into database; verified eligibility, plan information.
• Reviewed/processed/edited claims for filing manually or electronically using AOD (Answer on Demand) and Virginia Medicaid (DMAS) systems; appealed denied claims.
• Researched, resolved, documented unpaid claims with patient insurance companies.
• Conducted collection calls on past due balances for various charges.
• Covered Cashier’s office - balanced/maintained cash drawer, processed cash deposits, transmitted checks to bank.
St Agnes Healthcare System, Baltimore, MD Aug 2012 – Oct 2013
Medical Biller II/Patient Accounts Receivable Department
• Worked daily on 24-and 72-hour reports to bundle claims.
• Using Emdeon & Meditech systems, processed claims and holds, incompletes and rejections.
• Entered patient demographics and insurance information into medical claims software.
• Obtained information from insurance companies, internal departments to bill, resolve claims.
• Researched, corrected & resubmitted rejected claims.
• Complied with HIPAA regulations when receiving, sending medical records from the EMR.
Maryland Department of Health & Mental Hygiene Sep 2003 - Jan 2011
Division of Health Choice Customer Relations, Baltimore, MD
Medical Care Program Associate II
• Handles calls via queue center. Processed Medicare part A & B claims.
• Used EVS and MMIS state/federal computer systems to verify eligibility, benefits, coverage type.
• Contacted insurance companies, health care providers, other governmental agencies and recipients to verify information submitted to the Medical Care Program for payment and/or review.
• Interpreted and clarified Medical Assistance rules and regulations for the medical populations.
• Maintained routine and confidential files, logs and program data. Prepared reports.
• Handled suicide calls according to procedures, regulations.
• Cross trained on four hotlines: (1) Provider; (2) Enrollee Action; (3) Maryland Children’s Health Program Family Planning ; and (4) Primary Adult Care.
• HIPAA trained and certified.
EDUCATION & TRAINING
Fairfax County ACE Program, Fairfax, VA
• CRC Career Readiness Certificate Work Keys Assessment Silver Certificate
• Health Information Technology & Electronic Health Records
• Introduction to Dentrix
Catonsville Community College, Catonsville, MD
• Introduction to Business Courses
Dulaney High School, Timonium, MD
HS Diploma
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