Angel L. Ware

**** ***** **** *****, ****, Ohio *4224

Phone: 330-***-****

Email: adtf7d@r.postjobfree.com

Objective: Customer Service Representative with excellent administrative skills seeking a position where a dedication to customer satisfaction and building customer relationships can be utilized.

SKILLS:

Excellent written and oral communication

skills

Meticulous attention to detail

Microsoft Office Suite Excellent organizational skills PROFESSIONAL EXPERIENCE:

Crystal Clinic Orthopedic Center

May 2021 –

Present

Patient Access Representative II/Insurance Authorization Coordinator

• Registers patients in an accurate, efficient, and professional manner

• Conducts patient/guarantor interviews, explains hospital policies, financial responsibilities and patient Rights and Responsibilities and Notice of Privacy Practices;

• Follows check-in procedures consistently for all patients ensuring that all forms are collected, completed, signed, and scanned into systems; Verifies insurance eligibility for upcoming patient appointments using eligibility system.

• Collects referring physician demographic information for communication and follow- up

• Performs visit preparation, appointment reminders, records and tracks no-show patients, and other point of service activities as assigned.

• Handles a wide variety of patient inquiries (on the phone or in person) regarding appointments and services to ensure that patients can access CCOC services with minimal hassle or delay

• Identifies co-payments/out-of-pocket expenses and advises patients regarding the need for payments at/or prior to the time of service

• Identifies patients in need of financial counseling to collect payments by following CCOC policies and guidelines

• Facilitates the cash collection, as needed, for services rendered and ensures payments received are balanced and batched correctly according to CCOC policy

• Schedules appointments accurately by following specialty and physician-specific guidelines and/or routes the patients to the appropriate area for further follow-up/ scheduling

• Processes internet appointment requests and responds to patient according to departmental policy

• Ensures same day add-on appointments are communicated to appropriate department personnel and authorization is obtained

• Schedules all follow-up appointments or procedures using Electronic Medical Record

(EMR) systems and provides proper patient instructions.

• Collects referring physician demographic information for communication and follow- up

• Performs visit preparation, appointment reminders, records and tracks no-show patients, and other point of service activities as assigned

• Communicates with physician’s office when prior authorization/pre-certification are required and not yet on file in systems.

• Escalates to Patient Access leadership and provides detailed timeline of events as needed.

• Communicates to nursing, physicians, technicians, secretaries, and supervisors regarding issues relating to patient wait times, late arrivals, or other delays.

• Recruits, registers, and trains patients on how to use Patient Portal systems.

• Provides back-up coverage and assists in daily office routine when needed in other areas.

• Maintains confidentiality of sensitive information including, but not limited to, patient records, charts, hospital documents and employee information without exception, according to HIPAA guidelines.

• Maintains up-to-date knowledge of computer systems, insurance / government regulations and Patient Access policies/ procedures used within CCOC.

• Performs insurance verification and obtains initial and subsequent preauthorization for services, including procedures, surgeries, medication, injectable, imaging and DME.

• Submits, processes, tracks, and follows up on all referrals requested by providers in a timely fashion.

• Establishes an effective and highly efficient workflow ensuring insurance-based authorizations are obtained for all diagnostic procedures

• Performs insurance verification and benefit check for all patients prior to scheduling

• Manage Orders submitted to Imaging Facilities and outside Referral Networks and obtain prior authorization as needed.

• Manage Orders submitted to Specialty/Local Pharmacy and obtain prior authorization as needed.

• Communicates with physicians and department staff when there are issues with authorization

• Knowledge of the principles and practices of physician billing, out of network benefits, collection administration, industry and government regulations and reimbursements.

• Contacts insurance companies via phone and/or web to verify client’s medical benefits and provides Insurance with basic clinical information in patients chart to justify medical necessity

Codeblue

March 2020 –

February 2021

Managed Repairs Specialist

• Responsible for daily implementation of file management

• Exemplary customer service

• Demonstrated strong written and verbal communication skills in correspondence with clientele

• Made outbound and took inbound calls to address claims inquiries

• Used problem-solving abilities to determine appropriate course of action for client

• Efficiently and accurately entered data and other relevant information into client claims database and other business applications

Cardinal Health

November 2019 –

February 2020

Billing Authorizations Representative

• Took inbound calls to discuss policy with patients

• Verified coverage

• Updated insurance and billing information to ensure accuracy

• Reviewed policies and procedures

• Discussed billing options with patients

• Provided excellent customer services

Fastcomp

November 2018 –

September 2019

Bind Rater/Underwriting Assistant

• Reviewed request to bind and sent to carrier

• Took payment for policy bind

• Reviewed payment status to make sure payment cleared

• Updated system with policy documents and required information

• Reviewed quotes and sent to agent

• Trained and supervised bind rater team

Catastrophe Management Solutions

December 2011 -

Present

First Notice of Loss (FNOL) Specialist

• Received inbound calls for First Notice Of Loss

• Entering data into the system for items that were damaged due to incidents at the home Omega Title

July 2015 –

January 2016

Title Coordinator

• Requested documents from examiners regarding clients’ foreclosure

• Examined Tl and T2 paperwork to make sure all documents were included and completed

• Worked closely with escrow department to ensure funds were received and applied appropriately

Homesite Insurance

February 2014 –

March 2016

Customer Solutions Agent

• Attracted potential customers by answering product and service-questions

• Suggested information about other products and services

• Updated and maintained accurate customer records

• Facilitated product or service problem resolution (clarified the customer's complaint; determined the cause of the problem; selected and explained the best solution to resolve the problem; expedited correction or adjustment; performed follow-up to ensure resolution)

• Maintained financial accounts by processing customer adjustments

• Prepared product or service reports by collecting and analyzing customer information Millennium Capital And Recovery

May 2013 –

December 2013

Redemptions Coordinator

• Receiving inbound calls from debtors wanting to redeem their unit (vehicles, RV, Motorcycle, etc.)

• Putting Debtors cars on hold to avoid being moved off the lot.

• Releasing units back to the debtors and inputting payments Sterling Jewelers

January 2008 –

July 2008

• Organized and managed multiple billing accounts including medical accounts

• Performed data entry input

• Reviewed and analyzed account problems

• Reconciled and closed debtor accounts

• Proofread, edited, prepared, and mailed bills to debtors

• Adhered strictly to regulated deadlines

• Maintained confidentiality.

EDUCATION:

Bachelor of Science Florida Tech University Online, Tampa, FL Business Management/Healthcare Management (In progress) RECOMMENDATIONS AVAILABLE UPON REQUEST

Contact this candidate