Customer Representative Data Entry

AMY VAN SCYOC

***** ********* **** ** #***, Tampa FL 33637 352-***-****, 813-***-****

**********@*****.***

With over 7 years experience in the medical field, Medical Records data entry, medical records requests, and retrievals, Medicare appeals processing, grievance processing and medical office assistance, coupled with over 15 years as a customer representative, order support, technical support, at times holding leadership and educator roles, I know that I would be the best candidate to commit to empathetically and professionally handling either role with success.

Experience

● 10/2021 - 11/2021, 01/2022 - 04/2022

● Randstad Staffing/ Total Med, Centene (Wellcare, Sunshine Health Medicaid) Grievance Coordinator I, Provider Service Representative Researching Grievances from Medicare Beneficiaries and answering incoming calls from Providers 1) Researching various computer databases to validate various grievances made by Wellcare Medicare beneficiaries. Upon receipt of the medical records via electronic fax, they would transfer directly to our team of medical staff for a final review. Documenting all findings in each system used. Forwarding all findings to my supervisor and upon review, issuing apology letters or reimbursement for grievances that affected the members health. 2) Answering inbound calls from providers requesting a member's benefits and eligibility status, providing general claim status, claim payout amounts, assistance with claim disputes, refunds and recovery process. Advising if a provider was in network. Researching procedure codes to help the provider submit a pre-authorization and if it should be sent to us or a third party vendor. Assistance with issues using the provider's secure web portal. Advising providers on Appeal status and/or how to start an Appeal. Educating providers looking to become In-network with Sunshine Health. Providing correct contact information if I wasn't skilled to assist. Following HIPAA guidelines on each call.

● 10/2020 – 10/2021

● Tech support & Customer Care Rep, Computer Generated Solutions Assisting with the Sprint/ T-Mobile Network Merger Providing Technical Support and Customer Care Support (account information & billing assistance) answering inbound calls remotely, verifying all required information, asking empathetic & probing questions to best assist the caller. Trained for troubleshooting various devices with predetermined steps proven to get the customer back-up with services. Granted secure access to the Sprint/T-Mobile Cell cellular towers to search for network outages interrupting service. Handling billing inquiries, creating a payment arrangement, taking payments, blocking (and unblocking) services and/or numbers, and applying adjustments toward future bills. Educating the customer on all aspects of their Sprint/ T-Mobile account. Granted additional security to refresh network settings, change SIM cards and activate new phone lines and devices, reset devices, and answer numerous questions or concerns, to the best of my ability. If unable to resolve the customer’s technical issue the same day, I would schedule a call back appointment time and finish fixing the issues they may be experiencing.

● 10/2019 - 05/2020

● Medical Records Retrieval Clerk CIOX HEALTH, LLC Contracted by USF to assist with extremely high requests for medical records Answered inbound calls for patients of USF Physicians requesting a copy of medical records, cleared the fax request messages and fulfilled them each morning, assisted the walk-in patients with correctly filling out a Medical Records Release form, after HIPAA verification and logging patient ID information, I was tasked with extracting each requested record to be physically printed and handed to the patient. Responsible for all faxed STAT requests for medical records that were marked as urgent by Physician or treatment facility. Responsible for all incoming and outgoing medical records requests via fax. Amy Van Scyoc, Page 2

● 2/2019 - 5/2019

● Medicare appeals specialist KEPRO Medicare Appeals Providing assistance for Medicare recipients trying to file an Appeal Answering inbound phone calls from Medicare recipients and returning calls to members who left voicemails left previous night to explain the Appeal process and start an Appeal. Gathering all patient information to start the appeal, such as all member information, all medical records, dates, physician names, addresses, contact information, any other insurance information, and/or any additional facility information. Responsible for typing the member's reason for filing the Appeal word-for-word. Showing willingness to help and empathy to all members when asking for details. After speaking with the member, I was tasked with calling the providers office, assisted living facility, physical rehab facility to request medical records pertaining to the Appeal, advising the facility of the Appeal, and advising them of a 3 day timeframe to send all requested records in, educating the facility that all medical treatments must be continued until a decision was made on the Appeal, and to ensure all pages were dated and signed off by the physician.

● 11/2017 - 05/2018

● Medical Records Data Entry Clerk Healthcaresupport.com Staffing, Davita Medical Group Data Entry of Patients Office Visits and/ or specialist visits into correct Davita Primary Care Provider chart Responsible for ensuring that all clinical notes, specialist office visit notes were counted and correctly scanned and entered into the correct patient's medical chart according to alphabet and specialty. Reviewing each record to ensure the rendering provider had signed off on the visit notes and dated correctly. Responsible for ensuring the Davita Primary Care Physician received any records they had requested to be printed out and faxed. Education:

8/1995 - 5/1998

Harrison Visual and Performing Art Center

High School Diploma, GPA 3.4

General Studies, Advanced Placement Visual Arts

Skilled In:

● Working Knowledge of Windows XP - 10

● Microsoft Office, Outlook, Excel, Internet Explorer

● Accessing a Virtual Private Network daily

● Currently working remotely

● Quiet secure place to work, with Ethernet connection, Epic, Athena health, Cerner, eClinicalWorks, and 75Health

(CHERT COURSE CERTIFIED)

● Knowledge of Medicare and Appeals System (CHERT)

● Home Internet, Cellular Phone, desktop, Headset with mic

● Fiber Optic Internet Service Provider

● Salesforce,

● General Office Duties: copying, faxing, telephone, emailing, filing, data entry (35 WPM), scanning, taking phone calls, logging calls, verification according to HIPAA regulations

● Knowledge of Laws surrounding Medical Record Release,

● Knowledge of storage on a PC Box, OneDrive, Google Drive

● Knowledge of Medical Terminology

Personal and professional references available upon request. Any older Job history can be discussed in person. Please try to reach me via email at **********@*****.*** prior to reaching me by phone

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