Customer Service professional over 25 years
Resume:
Ana Roman
Customer Service/Call Center-Financial/Accounting and Medical Billing and Re-
Authorization Professional
Newport News, VA 23602
***********@*****.***
Multi-faceted, proficient and reliable professional individual with over 20 years of customer service call center and administrative experience in the financial industry. Over 5 years of Medical office experience with Billing and A/R as well as experience in Re-Authorizations for Specialty drugs. I possess superior relationship building, research and communication skills. A client-focused, self-starter with a strong ability to multi-task in fast paced environments. Welcomes challenges and executes consistent results with excellent interpersonal and organizational skills, great attention to detail along with a strong work ethic.
Authorized to work in the US for any employer
Work Experience
Revenue Cycle Management Specialist
Bioscrip now Optioncare - Remote
April 2016 to Present
• Worked in several different departments within the Revenue Cycle umbrella. Currently responsible for all Re-Authorizations of chronic disease drugs all while maintaining confidentiality of patient and proprietary information and observing legal guidelines for safeguarding the confidentiality of patient and proprietary Option Care information and providing excellent customer service
• Responsible for reviewing reauthorization reports to ensure submitting timely re-authorization requests to insurance companies
• Proactively maintain relationships with the Chronic Account Executives, internal and external contacts, dispensing branches, medical offices and patients. Communicates any possible delays, issues or denials
• Review patient accounts for current orders, clinical, labs and or any supporting documentation to ensure when getting ready to submit to insurance companies for review. Work any unfavorable outcomes in a timely manner by working with the referring practitioners, chronic account executives and the patients if needed to overturn unfavorable outcomes into favorable.
• Reviews patient's insurance company portals to understand drug policies and manuals for home infusion therapy/medication to ensure that we have what we need to submit a reauthorization packet Other responsibilities include: Researching and Resolving claims on hold due to numerous different reasons and other department responsibilities assigned by management. Previous responsibilities:
• Submitted timely, accurate invoices to payer for products and services provided. Verified the services and products are correctly authorized and that any required documentation is on file. Process all invoices by reviewing the HCPCS and pricing/units to ensure that its correct so the claims pays correctly the first time. Review patient accounts to ensure their insurance eligibility will cover the provided services for the specific date of service.
• Understands the terms and fee schedule for all contracts for invoices are submitted
• Responsible for ensuring that I am kept abreast of any pricing and or reimbursement policy changes for the payors that I am responsible for. Research why a claim is denied and make the proper changes to have a corrected claim sent and reprocessed.
• Communicate with patients if insurance information on file has changed and responsible for obtaining new insurance information.
Other clerical duties as assigned by branch manager Office Manager
Integrative Manual Therapy & Wellness
2014 to 2016
Responsible for administering reception, scheduling, insurance verification, medical records, clerical functions, and coordination office activities. Oversee medical records operations and procedures under guidelines of the practice. Assigns CPT, ICD-9 ICD-10-CM and modifier codes. Review patient charge information and makes sure charges are entered in a timely manner based on dates and cutoffs as well as ensuring patient confidentiality in accordance with the HIPAA. Responsible for preparing, reviewing and transmitting claims to the appropriate insurance as well as responsible for collecting on outstanding patient invoices and running daily patient reports. Perform miscellaneous activities in support of the facility Senior Client Services Representative
American Funds
2012 to 2014
Responsible for providing superior client service to financial advisors and investors throughout the country by helping clients manage their mutual funds accounts by completing online account transactions such as investment redemptions, purchases and account maintenance. Educate financial advisers and investors on American Funds services and broader industry policies. Answer questions on policies and procedures for existing retirement plans such as IRA's, SIMPLES, and SEPS.
Research and Resolve client inquiries in a timely manner Responsible for serving our Spanish Speaking clients on basic transaction requests Accounting/Billing Specialist
Brinks Inc
2009 to 2012
Responsible for all general record keeping including accounts payable, monthly invoicing of all local, regional and national customers as well as accounts receivable for the Annapolis Junction, MD branch, responsible for gathering and consolidating all accounting data for client files. Client contract maintenance as well as researching and responding to all inquiries from clients both externally and internally, in charge of preparing refund requests for duplicate and over payments and served as a liaison between Sales and Business Support departments regarding any billing and receivable issues. Reviewed AR reports and work with branch personal to coordinate payment or resolution as needed, in addition to assisting with contacting clients for payments. Special projects as assigned as well as strict adherence to deadlines and due dates assigned by branch manager and regional personnel Client Relationship Marketing Representative
American Funds
2006 to 2009
As a team member I worked closely with two Senior Vice Presidents and Dealer Relationship Managers who are responsible for building and enhancing relationships with the top five Broker Dealers in the country. Built and maintained relationships with internal and external marketing associates resulting in smoother execution of assigned projects. Responsible for education and training budgets for Broker Dealers in excess of 3.5 million dollars a year. Strong event planning skills, successfully executed over 30 Education and Training events annually attended by over 3500 attendees Assisted in preparing marketing strategies executed for American Funds exposure within major broker dealers in order to align their initiatives along with ours
Coordinated team administrative activities which resulted in less duplication of work and more efficient processes
Responsible for calendar management and client scheduling and maintained extensive contact management system
Served as the key person for central coordination of all of their administrative activities and managed charge expenses, including generating expense reports Several Positions
American Funds - Norfolk, VA
2001 to 2009
Several Positions
Marketing Support Representative
American Funds
2004 to 2006
Provided marketing and administrative support to two external Sales Force wholesalers who managed between one to two billion dollar territories in the states of New York and Pennsylvania Build relationships with financial advisers and their assistants in the territory Monitor the territory business plan for adherence and research/ address any service issues that may arise on behalf of financial advisers
Provide mutual fund and statistical information to financial advisers Responsible for providing monthly updates regarding broker dealer information Conducting administrative tasks including scheduling meetings, preparing expense reports, coordinating travel arrangements, event planning including shareholder and public seminars and broker dealer regional meetings
Adviser Marketing Representative
American Funds
2001 to 2004
Provided pre-sale marketing support to financial planners and financial advisers throughout the country Used extensive mutual fund industry knowledge to educate advisers on fund objectives, retirement planning, running hypothetical illustrations and providing statistical information on our mutual fund products and the market
Education
Bachelor's in Social Sciences -Criminal Justice
Virginia Wesleyan University
High school diploma or GED
Skills
• Administrative Professional (10+ years)
• Microsoft Office (10+ years)
• Customer Relations (10+ years)
• Client Services (10+ years)
• Front Office (4 years)
• Front Desk (4 years)
• Reception (10+ years)
• Bilingual
• Answering
• Medical Billing (5 years)
• Invoicing
• Invoice
• Elite
• Insurance Verification (5 years)
• Calendar Management (5 years)
• Computer literacy (10+ years)
• Customer service (10+ years)
• Medical Terminology (4 years)
• Accounts Receivable (4 years)
• Medical Records
• Expense Management
• CPT Coding
• Spanish
• English
• Medical office experience (6 years)
• Medical receptionist
• Data entry (10+ years)
• Documentation review
• Medical scheduling
• EMR Systems
• Patient Care
• ICD-9
• Microsoft Outlook
• Microsoft Excel
• Microsoft Word
• ICD-10
• Content management systems
• HIPAA
• Office Management
• Phone Etiquette
• Medical Coding
• ICD-10 (5 years)
• Windows
• Epic
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