Call Center Customer Service

ZEPHINE KING

**** ****** ** ***** ******** Hills, TX 71680 469-***-**** *******.******@*****.***

PROFESSIONAL PROFILE

Customer service focused professional with strong leadership skills; facilitates efficient workflows and communicates effectively with co-workers, patients and staff. Follows policies, procedures and guidelines to assure consistent quality. Maintains and ensures patient privacy and confidentiality.

Work history includes 10+ years of varied healthcare industry experience.

Focused, detail and results-oriented, with ability to identify objectives and bring issues to resolution in initial phase.

Ability to provide comprehensive support to all staff levels as well as supporting operational/administrative functions.

Skilled and competent in office administrative functions, conflict resolution, and financial statements.

CORE QUALIFICATIONS

Practice Structure Leadership & Management Medical Terminology

Business Office Operations Medical Office Procedures HIPAA Compliance Anatomy & Physiology

Human Resource Management Organizational Improvements Practice Management Software

Electronic Health Records (EHR) Electronic Medical Records (EMR) Greenway

Healthcare Computer Information Systems Medical Practice Management Systems

Accounting, Payroll, and Banking Systems Healthcare Law Insurance Billing Procedures

Healthcare Claim Cycle Insurance Verification

Maintaining Prescription Line Appointment Scheduling Charting Filing Processing Co-Payments

PROFESSIONAL EXPERIENCE

Molina Healthcare Irving, TX 12/2015-Present

Sr. MSR Representative for Medicaid & Medicare

Responds to incoming calls from members and providers excluding provider claims calls.

Accurately records all calls as applicable.

Achieves individual performance goals as it relates to call center objectives.

Assists callers with Web Portal registration and utilization.

Engages and collaborates with other departments as applicable.

Verify eligibility for provider and members

Reasonable for giving status of authorizations & Benefits for the provider’s.

Verified Registry provider through the NIP Registry for if we couldn’t find the provider company.

Worked with Medi-Cal member and Idaho member SIP-FIC for behavioral health & duals plans.

Omega OBGYN Associates, Arlington, TX-Temp Agency 06/2013 – 12/2015

Front Office Specialist

Retrieves and enters information into patients’ medical records via Greenway Prime SUITE software.

Schedules appointments, collects payments and handles day sheet balances.

Answers phone calls, faxes, and makes copies of medically related documents.

Follows HIPAA policies, procedures, and guidelines to ensure patient confidentiality.

Teladoc – Lewisville, TX 12/2011 – 03/2013

Member Services Associate

Represented Teladoc to members and clients in a courteous and professional manner,

Interacted with various departments to obtain information, resolved outstanding member and client issues, and provided members with detailed information.

Answered inquires related to billing questions, input and updated member information, documented customer interactions, and ensured HIPAA compliance.

Made decisions concerning removal of consult fees and associated service charges.

Medical City Hospital – Richardson, TX 10/2006 – 09/2011

Admissions Specialist

Greeted patients, obtained demographic and insurance information, and verified accuracy of appointments.

Presented and explained legal, ethical, and compliance-related documents.

Collected insurance co-payments, self-pay deposits, and patient balances.

Talecris Plasma Center – Dallas, TX 09/2002 – 10/2006

Phlebotomist

Assisted in determining the suitability of donors to undergo plasmapheresis prior to venipuncture.

Drew blood samples, and monitored donor and equipment to ensure patient safety and quality of product.

Set up, disconnected, and operated automated plasmapheresis machines.

Ensured proper calibration and maintenance of autopheresis machines and associated equipment.

Maintained accurate and thorough documentation.

Built rapport with donors to ensure customer satisfaction with the center to support a long-term donation relationship.

EDUCATION

Ultimate Medical Academy Associate of Science Degree – Healthcare Management, 2016

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