Medical Billing Customer Care

Channing Jarvis

**** ****** **** *** **** Dallas TX 75217

Cell 469-***-****

Email: *********@*****.***

Professional Summary:

** ***** ** ********** ********* customer support in busy call center environments for medical and insurance industry.

I am an unwavering commitment to customer service, with the ability to build productive relationships, resolve complex issues and win customer loyalty.

Strategic-relationship/partnership-building skills -- listen attentively and solve problems creatively. Proficient in systems as; Customer Interface (CI), Customer Care Portal (CCP), Premium Billing System (PBS), Integrated Pharmacy Network System (IPNS), Litton, and the Medicare Government website.

Effective verbal and written communication

Type 40-50 wpm

Processing medical claims

Reading Explanation of Benefits for posting and paying out payment- Patient’s demographics

Strong knowledge of CMS-1500

Knowledgeable in contacting insurance companies to verify patient’s insurance to calculate co-pays, co-Insurance, and deductibles

Broad knowledge of medical terminology, anatomy, and physiology

Proficient in systems such as Med Ware, Microsoft Word, Microsoft Excel, EMR, EHR etc.

Knowledgeable of Medicare, Medicaid, Blue Cross and Blue Shield, Workers Compensation, and other Insurance companies

HIPAA Certification

Education:

Everest College Dallas, TX

Graduate in 2006 with a Diploma in Medical Billing and Coding

(Honors)

Presidents List- Obtained a 4.0 GPA

Dean’s List- Obtained a 3.5 GPA

Worked Experience:

Fidelity Medicare Services 08/2021-12/2021

Customer Services Support (Remote)- Supporting our sales marketing efforts by fielding Medicare inquires and facilitating the client engagement with our staff. Engage with customers on a regular basic answering question and deliver a superior customer services experience. Ability to meet sales goals. Fielding, Medicare inquiries from multiple sales channels. Coordinating and scheduling appointments between out clients and sales team. Providing post enrollment customer’s service. Explain the benefit and features of various Medicare plans when needed.

Superior Medical Management 02/2020- 08/2020

Admin Assistant (Remote)

Grievance and Appeal specialist calling Insurance to check status of denied claims.

Knowledge of medical billing and appeals

Completing 30 appeals a day

Calling commercial insurance, Medicare payors, BCBS, Aetna etc.….

Getting denied claims overturn for payments

Submitting corrected claims, AOR document, Medical records

Alliance Family of Companies 07/2018-08/2019

Insurance & Benefits Verification Specialist

Verify eligibility and benefits on patients

Obtain verbal and written authorizations from appropriate source

Resolve discrepancies and problem solve

Coordinate with referring offices for complete patient information

Communicating with patient on authorization and referral status.

Explain procedures to patients prior to conducting studies

Utilizes knowledge of age specific needs of patient in performance of duties and responsibilities

Perform other duties as assigned

AmerisourceBergen 10/2014-07/2018

Benefit Investigation Specialist

I contacted insurance companies on behalf of the physician’s office to verify patient benefits. Asking appropriate questions regarding patients’ Benefits, complete data entry, and/or forms to document patients’ benefits coverage

Completing prior authorization research

Assisting by locating coverage options for uninsured and underinsured patients

Offering customer service outreach

Informing with coding support and billing inquiries

Primary Duties and Responsibilities:

Work with public and private payers, handle benefit insurance inquiries at assigned facility

Interface appropriately with insurance administrators, physician’s offices, patients and internal personnel.

Develop and maintain close interface with all components of the benefits process

Ensure that related information is obtained, documented in detail, tracked and available for access & amp.

Quality review

Comply with all appropriate policies, procedures, safety rules and regulations

Perform related duties as assigned

Work from home for 4 months. 10-01/2017-02/28/2018

All Medical Staffing/Quest Diagnostics Sept/2013-March/2014

Customer Services Representative

My responsibilities consist of contacting 120 Plus Doctors, Hospitals, and Labs regarding patient & lab result. The results could consist of Critical, Abnormal, Test Not Perform and STAT.

I educate clients the reason why a test was not performed and help provide them with the correct test code, collection container and transport temperature.

I also add the correct test codes when they are provided to me and if needed.

Southwest Airlines June/2013-Sept/2013

Customer Relations

Received 120 emails plus daily, categorizing them and sending them to prospective departments.

Scanned mail and distributed them to the correct files.

Aegis/Humana Oct/2006-Feb/2013

Humana Customer care Specialist

Responsibilities consisted of assisting Humana Medicare Prescription/ Medicare Advantage drug plan members with billing/enrollment and pharmacy Related inquires. Also, completed verifications for newly enrolled Medicare members joining

Prescription/Medicare Advantage drug plans acted as a Subject Matter Expert (SME) that assisted fellow Customer Care Specialist and active Team Lead that assisted supervisor with managing team.

Promoted: Jan/2009-April /2012

Service Recovery Specialists

Assisted in development and coaching of customer service representatives this resulted in various departments maintaining a 95% quality average.

Excelled in achieving outstanding retention.

Delivered excellent customer service at 100% by resolving plan issues and complaints punctually and accurately, educating customers on how to utilize available plan benefits.

Recognized for contributing to a successful one-call resolution program initiative.

Completed ongoing training to stay well-informed on products, service and policy changes.

Humana July/2007- August/2008

Assist and Escalation Help Desk

Responsibilities consist of providing Guidance to Customer Care Specialists with the questions and diffusing Medicare member and Providers Escalated supervisor calls.

References available upon request

Contact this candidate