Service Representative Customer
Resume:
**** **** ***** ***** ********, TX ***** 210-***-****
MICHELLE WILSON
PROFESSIONAL PROFILE
Well-rounded professional backed by cross-functional medical billing, customer service, and call center experience. Provide timely and accurate data to ensure reimbursement for patient services. Follow policies, procedures, and guidelines to ensure consistent quality. Lead by example and set high standards for performance.
Work history includes referrals, payment posting, collections, billing, appeals, and Medicare experience.
Ultimate Medical Academy – HIPAA Essentials for Healthcare Professionals Certificate.
Well-organized, manages time and priorities to meet deadlines.
Attention to detail essential in generating revenue and maintaining accuracy.
Customer service skills necessary to communicate effectively with patients and healthcare providers.
Maintain confidentiality standards of protected health information in accordance with HIPAA guidelines.
Microsoft Office Applications (Word, Excel, PowerPoint, and Outlook) – Type 40 WPM with Data Entry skills.
KEY QUALIFICATIONS
Medical Billing Accounts Receivable Collections Co-Pay Deductibles Co-Insurance EOBs
Revenue Cycle Management Posting Payments Government (Medicare & Medicaid) Third Party Payers
Electronic Health Records (EHR) Electronic Medical Records (EMR)
Managed Care (HMO PPO POS) Workers Compensation
Insurance Verification Insurance Claim Processing CMS 1500 CMS 1450 (UB-04)
Front Office Operations Medical Office Procedures Scheduling Medical Terminology Anatomy & Physiology
HIPAA Compliance Medical Coding (ICD-10-CM HCPCS CPT)
EDUCATION
Ultimate Medical Academy Diploma – Medical Billing and Coding, 2020
Academic Honors Recognition / Honor Roll
Prairie View A&M University – Prairie View, TX ǀ Bachelor's Degree – Human Performance, 2000
RELEVANT PROFESSIONAL EXPERIENCE
University of Texas Health Science (ObjectWin) – San Antonio, TX 08/2021 – Present
Dental Billing Specialist
Interact with customers via inbound calls and work towards meeting goals and metrics.
Respond to questions, provide information, and ensure quality customer service.
Document activities and interactions in an accurate and thorough manner.
Maintain confidentiality of private personal information.
Bill Claims, Review EOBs and open accounts, Reprocess, Void and Appeal Claims
Refunds, Adjustments, Electronic Claim Filing through third party portables and EDI
Media Riders (DentaQuest) – San Antonio, TX 07/2021 – 06/2022
Customer Service Representative – Call Center
Interact with customers via inbound calls and work towards meeting goals and metrics.
Respond to questions, provide information, and ensure quality customer service.
Document activities and interactions in an accurate and thorough manner.
Maintain confidentiality of private personal information.
Review, Reprocess, Void and Appeal Claims
Review, Extend, Appeal Authorizations
Imagine Children's Dentistry & Orthodontics– San Antonio, TX 04/2021 – 05/2021
Front Desk Coordinator - Dental Office
Obtained Insurance verification and benefit breakdowns with Commercial and Medicaid Insurances
Appointment Scheduling
Patient Check-In/Check-out
Patient charting and scanning of personal health record documentation
Maintain confidentiality of private personal information.
Multi-line telephone
Obtain and record patient co-pays/co-insurance and payments for claims.
Alorica (Universal City) – Converse, TX 06/2020 – 04/2021
Customer Service Representative – Call Center
Interact with customers via inbound calls and work towards meeting goals and metrics.
Respond to questions, provide information, and ensure quality customer service.
Document activities and interactions in an accurate and thorough manner.
Maintain confidentiality of private personal information.
The Platter Cafe' – San Antonio, TX 07/2017 – 11/2018
Restaurant Manager
Maintained a customer focused, team oriented environment by building effective employee relationships, overseeing shifts, and providing guidance and support to employees.
Trained new employees, entered data, and met company goals for productivity and sales targets.
Delegated job duties, resolved customer complaints, and answered inquiries.
Ensured guest satisfaction and upheld compliance with all regulatory requirements and brand standards.
Evaluated employee job performance, discussed issues, and worked to resolve problems.
Implemented policies, procedures, and customer service standards.
Teleperformance – Killeen, TX 10/2016 – 12/2016
Customer Service Representative (Contract Position) – Call Center
Interacted with customers via inbound calls to resolve customer inquiries.
Solicited sales of new or additional services or products and met established goals and metrics.
Took action and followed up to ensure timely and efficient problem resolution.
Entered customer data in an accurate and thorough manner.
Communicated in a clear and concise manner and worked effectively as a team member.
Transcom Outsourcing (AARP) – Converse, TX 04/2015 – 10/2015
MSR Agent / Customer Service Representative – Call Center
Processed payments for membership, handled complaints, and transferred calls to proper business partners.
Assisted with website registration.
Used RDS computer system, Ciboodle CRM software, Google Docs, Spark, and Empower.
OfficeTeam Staffing – Converse, TX 12/2012 – 08/2013
Billing, Loan Services, and Dispatch Contract Positions
Regulated gas and electric bills, reconfigured meter reads, and rebilled or invoiced corrected gas and electric bills.
Matched invoices with checks for payment processing, solved payment issues, and filed mortgage loan information.
Paid close attention to detail to ensure accuracy and completeness.
Dispatched buses on routes and helped customers with boarding pass issues.
Communicated with customer service centers at various depots in order to keep schedules on time.
Checked drivers in and out for routes.
AppleOne Staffing – San Antonio, TX 10/2002 – 06/2004
Medical Billing, Collections, and Insurance Claims Review Contract Positions
Processed medical referrals and insurance claims, prepared and sent referrals through appeals process, and posted payments from insurance companies and patients.
Researched delinquent accounts, reprocessed incorrect EOBs, and reviewed and corrected denied Medicare claims.
Determined steps to finish review process using Medicare compliance procedures.
Prepared claims for adjudication when necessary.
ADDITIONAL PROFESSIONAL EXPERIENCE
Healy Murphy Child Development Center – Converse, TX ǀ Teacher 10/2015 – 04/2016
Accountemps / Robert Half Staffing (SWBC Financial Services) – Converse, TX ǀ Mail Operations 06/2014 – 10/2014
Franklin Apartment Management – Converse, TX ǀ Leasing Agent / Customer Service 09/2013 – 01/2014
Higgs, Carter, King Gifted and Talented Charter Academy – Converse, TX ǀ 6th Grade Teacher 07/2011 – 06/2012
Family Service Association – Converse, TX ǀ Pre-K Teacher 08/2009 – 05/2011
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