JOY GREER

Customer Care Specialist

Bowling Green, OH

adnuwr@r.postjobfree.com

419-***-****

To secure a challenging and rewarding position where my professional integrity, interpersonal skills, and personal initiative will be fully employed to deliver positive results. Authorized to work in the US for any employer

Work Experience

Member Service Representative

Paramount Promedica Hospital - Maumee, OH

January 2021 to Present

As a Member Services Representative I ensure continued membership retention, growth and education by providing quality, professional, personalized service to all members according to Plan guidelines. I handle telephone, written and walk-in inquiries in a courteous, professional, thorough manner to assure member satisfaction and education. I use problem-solving skills and knowledge of benefits, claims/membership policies and procedures to assure correct application of benefits. I assess when further action is required by sending inquires promptly to research team for appropriate action. I utilize a variety of computer software programs and written materials to access information needed to assure accurate responses to questions. I provide assistance to the Member Services Department by performing special projects to aid in the smooth functioning of the department. I interact professionally and effectively with members, management and other departments demonstrating compassion, accountability, respect and excellence and thoroughly document all inquiries within 24 hours of member or customer contact. I provide input to management on problem trends or patterns to assure correct processing and/or enhance member education.

Referral Office Liaison

Metro Health Hospital - Cleveland, OH

November 2019 to January 2021

Responsibilities:

• Ensured accurate enrollment, registration, check-in and appointment scheduling for patients into MHS

(epic) by:

• Issued Medical Record Numbers to patients new to MHS.

• Captured complete demographic, insurance, and Guarantor information; entering that information into the appropriate system.

• Obtained appointment data, and communicating it back to the patient and/or referring provider.

• Accurately processed refill requests from patients and patients’ pharmacy within 72 hours as needed based on call efficiency needs.

• Obtained clinical follow-up data as requested by referring providers.

• Applied critical thinking to escalate urgent symptoms calls to team nurses for triage and medical advice.

• Responded to all callers in a professional manner; escalating problem calls to the supervisor for resolution.

• Communicated with physicians, staff, insurance companies, and/or other departments to obtain additional necessary referral information as needed.

• Relayed referrals/authorization information to patients/providers, securing authorization numbers, and entering this information into the correct information systems.

• Monitored appointment availability in MHS departments, and scheduling referral appointments.

• Cross-scheduled referral appointments as able, and/or obtaining appointments from departmental staff.

• Ensured that referrals are linked to scheduled visits.

• Initiated outbound patient calls and follow-ups on primary care requests as needed based on coverage needs.

• Processed patient MyChart requests, and provided desktop support to MyChart users.

• Processed referrals from external providers and facilities.

• Entered referral information in a timely manner using the correct information systems. Direct Support Professional (DSP)

Woodlane Residential Services - Bowling Green, OH

August 2007 to September 2017

Direct supervision with the appropriate level of assistance and training to residents with dual diagnosis disorders, Mentally Developmentally Disabled (MDD), and Severe Persistent Mental Illness.

• Developed Individual Service Plans (ISP), Behavioral Shaping Plans (BSP).

• Assist residents in meeting behavioral/social skills.

• Maintained accurate documentation/records per Medicaid and Licensure standards.

• Verified Insurance Coverage.

• Time management skills used everyday.

• Knowledge of Trauma Informed Care principles

Responsible for coordination of all medical services and appointments to ensure quality health care for residents.

Education

College Degree Certificate in Medical Administrative Assistant with Medical Billing and Coding

Northwest State Community College - Archbold, OH

March 2021 to Present

High school diploma

Cleveland Central Catholic - Ohio

August 1984 to June 1986

Skills

• Customer Service (10+ years)

• Medicaid/Medicare (10+ years)

• Insurance Verification (3 years)

• Medical Terminology (3 years)

• Epic (1 year)

• EMR Systems (2 years)

• Medical Scheduling (1 year)

• Desktop Support

• Triage

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