Medical Billing Customer Service
Resume:
Rachel Peters
Mira Loma, CA 91752
*************@*****.***
EDUCATION:
Medical Billing & Coding (Valedictorian Certificate GPA 4.00)
American College of Healthcare, Riverside, California, USA.
Pre-Med
American International Medical University, Saint Lucia
SUMMARY OF SKILLS:
Experience with HMO’s, Medicaid & Medicare, Medical Terminology and Human Anatomy, Knowledge of Insurance companies & Claims, Medical Billing Insurance procedures, MS Word & Excel, Electronic Remittance advice, Medical Billing Software, Typing 59 Wpm, HIPAA, Professional phone demeanor. CPR/BLS Card, ICD-10CPT & HCPCS and experience with EMR.
WORK HISTORY:
Customer Service Represenitive and Order Fulfillment Associate
Home Depot, Mira Loma, California, December 2019 - October 2020
A Customer Service Represenitive main goal is to dedicate excellent service and efforts to maintain customer satisfaction and contribute to company success and to also devote to the highest level of customer service through efficient team and customer account management.
Skills and Responsibilities:
Department Sales, Lead Generator, Pro & DIY Account Sales, Sales Specialist, Special Services, and Customer Order Specialist.
Preparing delivery, online, and will call orders for customer merchandise
Handling all cash and credit transactions regarding Returns, Purchases, Exchanges, Credit card payments Store discounts, Military discount and Will Call and Phone Sales transactions.
Inbound calls regarding online orders, updates, cancelations and online order refunds, store inventory, item availability, engaging tasks and aiding to service upon requests from other Home Depot stores including verifying, making correction and alternating special online orders.
Outbound calls regarding online orders such as updates, delivery updates, cancelations, order pick up, alternating pick up or delivery dates, tracking order and noting order and task completions. Order product availability.
Work in cooperation with their Department Supervisor’s and other associates in their department as well as other departments outside of the assigned departments to ensure quality performance and manage and ensure completion of task’s in a timely manner
Customizing Special orders such as installations for kitchen appliances, flooring, garage doors and other home installations
Working overtime to ensure efficient customer service to improve and exceed over-all sale operation goals and over-all customer satisfaction in order to sustain the companies vales and duties.
Managing online orders including assisting and guiding customers through the website to successful and efficiently process online purchases and also in-store phone sales.
Accurately inputting customer shipping information, and then using a commercial label printing machine to print the shipping labels.
File delivery confirmation and contact customers when situations arise with their orders.
Must work and communicate with other Home Depot stores to ensure customer receives their merchandise even if it does not all come from the same location.
Educated customers on product and service offering.
Helped customers select products that best fits their needs
Resolving online order issues by reaching out to online comprehensive customer service representatives to future assist customers on extended issues recording pending tractions, will calls and order cancelations, alternations and other inquiries including Home Depot credit card disputes, and registration approvals.
Service DIY customers and specialist in providing advice on diverse customer situations
Training newer team members in all aspects of operations, store safety, special orders with meticulous attention to details.
Greeting customers upon entrance.
Resolved product issues customer conflict/ relations /complaints and adjustments on online orders and in-store products to best effects and resolved customers regarding product issues and shared benefits of new technology.
Assist customer over the phone regarding store operations, products, promotions and orders.
Assisting customers with merchandise work well as a team member generate sales and inventory.
Managed quality communication, customer support and product representation for each client.
Involved with all aspects including answering questions.
Other Job Functions and Attributes:
Strong Organizational Skills, Sharp problem solver, Energetic work attitude, Reliable work ethics, Adaptive team player, Perceptive to quickly adapt to tasks, duties and responsibilities, Ambitious with wiliness to grow gradually through the company and accelerate upon experience and guidance to further benefit personal growth professional and the company brand, Conflict resolution techniques, Meticulous attention to detail, dedicated to process improvement, active listening skills, high customer service standards.
Prior Authorization Coordinator, Claims Coordinator
Agilon Health, Corona, California, September 2018 – February 2019
Received inbound call appropriately to provider, or member, questions and/or concerns. Answered calls timely and in accordance with the performance standards established within the customer service department.
Provided information as requested related to coverage determinations and appeals processes.
Provided information as requested by caller related to claims and authorizations.
Facilitated provider and member communications related to network providers.
Responded to provider dispute queries.
Provided plan contact information as applicable to members and providers.
Facilitated communication through the Language Assistance Program (for members who are not English proficient) of the various plans, and/or arranges for interpreter, including interpretive services for the hearing impaired.
Maintained applicable and timely records and files regarding member and provider communications and service coordination.
Reviewed all documents received for completeness, verifies eligibility member
Verified claims status and coordinates information, as applicable, with provider and claims staff.
Forwarded calls as appropriate to supervisor or other staff for further response or follow up.
Ensured confidentiality of all hard copy, electronic, and verbal communication, and adheres to organization’s policies related to privacy and disclosure.
Promoted a positive image of the organization and the department in all aspects of communication and contact.
Performed other duties as assigned.
Other Job Functions:
Understand, adhere to, and implement the Company’s policies and procedures. Provide excellent customer services skills, including consistently displaying awareness and sensitivity to the needs of internal and/or external clients. Proactively ensuring that these needs are met or exceeded. Take personal responsibility for personal growth including acquiring new skills, knowledge, and information. Engage in excellent communication which includes listening attentively and speaking professionally. Set and complete challenging goals. Demonstrate attention to detail and accuracy in work product.
Externship
Option Care, Corona, California, February 2019 – May 2019
Applied notes to invoices for denial/correspondence claims and letters. EOB’s. Communicated with different insurance companies. Forwarded notes to assigned clerks and collectors. Applied all payments received by insurance, patients, and credit agencies to accounts. Familiar with applications such as MRO and I emphasis and CPR-Pharma point.
Medical Records Clerk
Medicine Shoppe Pharmacy, Riverside, California, May 2017-January 2019
Prepares new patient charts. Gathering documents and information from paper sources/electronic health records. Ensures medical records are assembled in standard orders and are accurate and complete. Creates digital images of paperwork to be stores in the electronic medical records. Files paperwork and reports in patients charts ensuring they are completed in timely manner. Codifies patients medical records to enable them get reimbursement from their employers or insurance company. Maintains and regularly updates medical records in soft copy and in easily retrievable form.
San Miguel Pharmacy, South Gate, California, November 2016 – March 2017
Responsible for handling customer transaction. Process payments as well as bag prescriptions. Answer patient’s questions related to prescription plan advantages. Maintain and manage over counter drug products, order, and stock adequate inventory.
Hospital Admitting Clerk
C.S.I. Hospital, Bangalore, India, June 2014 – August 2016
Interviews incoming patient or representative and enters information required for admission into computer. Obtain and record name, address, age, persons to notify in case of emergency, attending physician, and individual or insurance company responsible for payment of bill. Enters patient admitting information into computer and routes printed copy to designated department. Obtains signed statement from patient to protect hospital’s interests.
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