Call Center Service Representative
Resume:
Quintera Bookman
Houston, Texas 77028
************@*****.***
Summary of Qualifications: Over ten years of experience within the medical field. Broad health insurance, healthcare, managed care, medical claims, revenue cycle and EPIC specialization knowledge. Strong leadership, interpersonal, time-management, and analytical skills. Ability to work in and support a multi-project environment. Creative and tenacious in overcoming obstacles, meeting deadlines and conflict resolution. Enthusiastic and committed to providing excellent training and staff development.
Professional Experience:
Houston Methodist Hospital
Patient Services Representative 12/2022 to Current
Functions in a Surgery Scheduler capacity while also completing Patient Service Representative job duties
Surgery scheduling for multiple surgeons.
Surgery insurance authorizations.
Device and product representative surgery assist scheduling.
General surgical assist scheduling.
Authorization denials and peer to peer scheduling.
Organizing and adjusting surgeon’s clinical schedule.
Scheduling in office procedures.
Insurance authorization and verification for in office procedures.
Insurance verification for clinic daily schedule.
Patients check in and check out.
Answer incoming patient appointment scheduling calls.
Outbound patient appointment scheduling calls.
Surgery payment collection.
Appointment payment collection.
Internal patient referrals.
External patient referrals.
Houston Methodist Hospital
Patient Access Coordinator 07/2016- 04/2022
Functions in a lead capacity over in office scheduling call center.
Primary point of contact for resolving questions and issues pertaining to patient scheduling and clinic processes and protocols.
Serves as the liaison between management, call center staff, physicians/physician offices, insurance providers, and others for scheduling, clinical and patient escalations.
Provides operational support under the direction of Houston Methodist Leadership.
Assist in organizing work schedules and assignments.
Direct EPIC, CISCO finesse and process training with all incoming scheduling center and front desk employees.
Trained and assisted employees with labor work, timecard adjustments and PTO submissions.
Conducts quality assurance audits through Calabrio call monitoring system.
Provide feedback to manager on staff performance and developmental needs,
participate in the development staff.
Lead, organize and regularly perform departmental special projects.
Contributes to a positive work environment and to a dynamic, team focused work unit that actively helps one another to achieve optimal department results.
Collaborates with all members of the interprofessional health care team by actively communicating and reporting pertinent patient care information and data in a comprehensive manner.
Insurance Authorization and Verification via RTE and phone.
Performs patient check in/check out functions.
Received Inbound escalated patient calls. Performed escalated outbound patient calls.
Coordinates patient flow as directed with consistency, timeliness, and expert skill while meeting appropriate priority standards.
Provides appropriate notification of issues that may result in service delays or denials.
Handles add-ons, reschedules, and cancellations appropriately and as per department protocol.
Communicates to resolve patient access and quality service matters. Keeps open channels of communication with physician, patient, and service areas regarding action taken and resolution.
Enters patient and operational data into various database systems with a high level of thoroughness, accuracy, and timeliness.
Ensures patient information is conveyed to others appropriately while complying with patient
confidentiality and HIPAA regulations
PAS (Patient Accounts Services, LLC.) Houston, TX
Call Center Supervisor, 10/2011 – 9/2016
Insurance Verification- contacted the patient’s insurance company to verify coverage levels and works with individuals to educate them on their benefits information. Retrieved and entered the patients.
insurance information in an accurate manner. Updated the patient’s information in the organizations.
insurance system and verified that the existing information is accurate.
Collections- responsible for daily collections and the management of client, team, and company collection goals.
ADP Payroll – created and updated agent schedules. Approved and corrected employee’s timecards. Reviewed employee time off request.
Support Contact Center Manager – active managerial role in the day-to-day operational functions in achieving daily call center service levels and performance guidelines.
Delivered on the job training and classroom instruction in technical subject matter, system applications, corporate initiatives, and professional development. Designed training materials and job aides. Reduced transition from training environment to production by 50%. Computer literate.
Assigned multiple projects and department initiatives – Grievance & Appeals Facilitator, solely responsible for resolving hospital inquiry escalations, facilitated resolution of issues between staff liaisons and the client. Managed and ensured timely responses from the client.
Managed Email Billing Solutions application. Responded to complex billing cases via email within a two-day business timeframe in a professional and efficient manner.
Assisted in the redesign and development of department workflows and policy & procedures – conducted training to team on new processes.
Handled inbound and outbound calls in a blended environment with excellent proficiency.
Effectively used all supporting applications for call tracking and history.
Assess customer complaints, handle billing inquiries, and provide adequate resolution.
Proficient in overcoming customer dissatisfaction, providing exceptional follow-up and customer service retention.
Persuasive communicator with well-developed presentation and negotiation skills. Able to develop productive relationships with colleagues, customers, direct reports, and staff at all levels.
Team Building- Created and implemented weekly team building exercises.
Team Meetings- Created material and facilitated weekly team meetings with the staff.
System Knowledge:
EPIC, Authpal, Availity, UHC, Cigna, BCBS, Aetna, Navi Net
Microsoft Applications: EXCEL, Word, PowerPoint
References Will Be Furnished Upon Request
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