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Verification Specialist Registration Representative

Location:
Dallas, TX
Posted:
April 20, 2022

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Resume:

LUSHUN ROBINSON

Dallas, TX *****

adqt0h@r.postjobfree.com

469-***-****

Obtain a challenging position that will utilize my current skills and provide opportunity for growth, development and advancement. Authorized to work in the US for any employer

WORK EXPERIENCE

Verification Specialist

Advanced Infusion Solutions - Dallas, TX

February 2020 to November 2022

• Verify, document and follow ups with patient's health insurance eligibility, benefits, coverage/non coverage information for intrathecal compounding medication.

• Initiation/extensions/appeals of prior authorizations via fax and phone.

• Supporting medical document request via phone and fax. Insurance Verification Specialist Level3

Cornerstone Staffing 2012 to

Present

Insurance Verification

● Verified insurance eligibility for hospital procedures via phone and web.

● Contacted Dr's offices informing of precertification requirements.

● Submit and obtain precertification's via phone and web. Insurance Verification Specialist L3

AllianceRx Walgreens Prime

November 2017 to February 2020

Specialty Pharmacy Insurance Verification

· Verify all Major Medical and Bluecard Accounts

· Initiate and obtain Prior authorization and Pre-Determination request via Scriptmed and Cover My Meds · Assist with PBM and Major Medical Call in line

· A/R Balance review

· Responsible for the BCBS Bluecard email box

· Assist Supervisor, team leads and agents with escalated accounts and calls · Review accounts to verify that correct plans are loaded and billed correctly Pre-Registration Representative

Baylor Scott & White Hospital

2015 to 2017

• Preregistered patients for outpatient procedure

• Verified accuracy of patient demographics

• Collect Copayments

Assistant Manager

Family Dollar - Dallas, TX August 2014

to May 2015

• Maintaining stocked floor merchandise.

• Clearing store for evening closings, deposits.

• Display setups

• Cashier

Medical Biller

WLS Surgical Associates, PA 2009 to

2011

Verify insurance eligibility.

● Input patient demographics and physician charges.

● Audit encounter forms/surgery charges for coding errors.

● Account receivable follow-up.

● Appeal claims denied in error.

● Assist patients with account inquiries.

● Check-In/Out Patients, Schedule Appointments, Prepare Charts. Order Writer

The Home Depot - Dallas, TX 2005 to

2008

Wrote orders and quotes for customers flooring and millwork home improvement jobs.

● Provided excellent customer service to customers via telephone.

● Trained new hires regarding order writing and customer service.

● Received C.O.E. (circle of excellence), Top 5% achiever award. Lead Service Representative

Greyhound Lines - Dallas, TX

2004 to 2005

• Handled emails, inbound calls, and outbound calls

• Booked appointments

• Managed customer accounts

• Assisted with technical support duties

• Performed data entry for All companies orders and customer information

• Handled billing issues and order inquiries

• Assisted customers with questions

• Assisted customers with a warm and professional attitude Leasing Consultant

Sunrise Village Apartments - Dallas, TX 2003 to

2004

Educated prosperous tenants on the apartment complex

● Collected rent

● Updated QuickBooks

● Supervised maintenance crew of 6

Technical Support Specialist

Protection One Alarm Co 1998 to

2002

Assisted technicians in trouble shooting

● Disconnected/ Reconnected alarm systems

Lead Service Representative

Greyhound Lines Incorporated - Dallas, TX 1996 to

1997

Handled escalated calls from passengers concerned with bus information.

● Assisted agents with questions and concerns of passengers.

● Educated passengers with fare and schedule information. ● Processed will call tickets for pick up. Sandford Brown Institute 2008

J.F. Kimball High School

1993 to 1998

I am a customer service driven individual with experience in a healthcare setting and knowledge of health insurance rules and regulations. Among my strengths is the ability to accomplish my goal at providing great customer service, while contributing to help meet goal requirements requested in order

• to be efficient for my team. This is due to my knowledge and proper use of software and material provided in order to achieve in my profession. I also have working knowledge of practice management applications, BCBS Bluecard Program, Scriptmed, PromiseNet, Pace, MS Window 95-2003, MS Office Applications, Mysis, Laser fiche, Siemens', Invision Trace Voice and Fax, Navinet, Availity, Care Connect, Lynx, CPR, Zirmed & 10 key (10+ years)

• Insurance Verification

• CPT Coding

• Medical Billing

• Medical Scheduling

• ICD-10

• ICD-9

• Medical Records

• Medical Office Experience



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