Service Representative Customer
Resume:
Patricia Davis
***********@*****.***
Location: Fresno Tx
Summary:
●Patricia has experience over 12 years as Customer Service Tele-Sales representative working with United Health, The State of Oklahoma, Memorial Hermann Hospital, etc.
●Proficient with insurance guidelines, HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
●Extensively used of computer systems, software, 10 key calculator effective communication abilities for phone contacts with insurance payers to resolve issues.
●Extensive experienced in answering patient questions regarding statements, posting guarantor payments, setting up payment plans within our policies, researching and resolving issues with accounts, connecting patients with financial counselling, communicating patient balances and meeting collection goals.
●Verified insurance eligibility and benefits and ensures all notifications and authorizations are completed within the required timeframes.
●Responsible to obtain insurance information, verify benefits, and secure authorizations.
Education:
High School Diploma – Forest Brook High school_1982
Medical Software Skills:
●EPIC
●Care Systems
●IDX.
●Health Quest
●Cubs
●Fastrac
●Advantix
●Solutions One
●Centricity
Remit Data
Professional Experience:
Flagstar Bank
July 2021 – Current
Call Center/Senior Collect Specialist Remote
The collections/Call Center duties were to ensure that calls are met on a daily basis. Includes an average speed of answer of 60 seconds or less, abandonment rate of less than 5 percent and a blockage rate of less than 1 percent. Receive customer phone calls to educate on payment. Handle Inbound/Outbound Customer Contacts by Telephone. Answer inbound telephone calls from and place outbound calls to mortgage borrowers that are 0-60 days delinquent. Handle basic technical calls, including how to submit financial documentation through flagstar.com Maintain familiarity with up to 10 systems and applications in order to research inquiries Use problem solving skills paired with knowledge of arrange payment and/or payment alternatives to cure delinquency Escalate issues to management and/or second levels appropriately Calculate and explain payment changes to customers Educate borrowers on loss mitigation options and refer borrowers to the Loss Mitigation department when appropriate Create and Maintain Documentation of Calls.
United Health Group Nov 2020 – June 2021
Customer Service Representative (Remote)
●As a Specialist of Customer Service performs all customer service and collection activities across the Revenue Cycle.
●Job duties include, but are not limited to, answering patient questions regarding statements, posting guarantor payments, setting up payment plans within our policies, researching and resolving issues with accounts that have been identified by patients, reaching out to appropriate departments to resolve any requests made by patients connecting patients with financial counselling department for charity screening, communicating patient balances, meeting collection goals as set by department, and providing excellent customer service for all of our patients.
●Must have knowledge of all areas of the Revenue Cycle.
●Communicate and partner with other areas of Ensemble and Revenue Cycle to resolve customer service issues. performs other duties as assigned.
The State of Oklahoma Apr 2020 – Nov 2020
Customer Service Representative (Remote)
●Education and Experience requirements at this level consists of those identified at Level II plus three years of experience in customer service, mail room operations, or technical clerical work; or an equivalent combination of education and experience.
●Answer inbound & make outbound calls assisting claimants with filing their unemployment claims & the status of current claims for unemployment benefits.
Empereon Aug 2019 – Feb 2020
Customer Service Tele-Sales representative
●Responsibilities were assisting existing or potential customers inquiring about our client’s products or services, using company and client-provided materials, guidelines, and policies.
●Maintains and improves quality results by adhering to standards and guidelines, recommending improved procedures.
University of Texas MD Anderson Cancer Center Apr 2019 – Jul 2019
Financial Clearance Associate
●Verifies the eligibility/benefits, pre-authorization requirements, available payment options, financial counselling, and other identified financial clearance related duties.
●Collaborates with Patient Access, payors, third party vendors, patients, and any other identified representatives internal or external to the institution to financially clear patients for care.
●Escalates financial clearance issues to the supervisor or coordinator for resolution.
Memorial Hermann Hospital Houston TX Oct 2018 – May 2019
Patient Access Specialist
●Schedule’s patient appointments and enters required information in the computer system in an accurate and timely manner.
●Obtains demographic, insurance and financial information from patient or guarantor. Enters information in computer system with a high degree of accuracy.
●Explains all required forms to the patient or guarantor and obtains the necessary signatures.
●Ensures medical necessity compliance by obtaining necessary data, reviewing Compliance System, communicating information to patient or guarantor, and obtaining necessary signatures. Protects the financial integrity of the facility by collecting patient liability, establishing payment arrangements, discussing payment options and screening for eligibility.
●Verifies insurance eligibility and benefits and ensures all notifications and authorizations are completed within the required timeframes.
●Post’s payments in the computer system and generates the appropriate patient receipts.
●Monitors, reviews, and resolves patient account issues on assigned reports.
●Communicates in an effective and professional manner with Physicians, ancillary departments, nursing units, physicians' office staff, insurance companies, as well as patients and their families (all Patient Access customers).
●Completes thorough and accurate documentation.
●Ensures safe care to patients, staff, and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity, and quality of service.
Methodist Hospital Mar 2016 – Oct 2018
Billing/Collections Representative
●Revenue Cycle
●Obtain referrals and pre-authorizations as required for procedures.
●Check eligibility and benefit verification.
●Review patient bills for accuracy and completeness and obtain any missing information.
●Prepare, review, and transmit claims using billing software, including electronic and paper claim processing.
●Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid.
●Follow up on unpaid claims within standard billing cycle time frame.
●Check each insurance payment for accuracy and compliance with contract discount.
●Call insurance companies regarding any discrepancy in payments if necessary, Identify and bill secondary or tertiary insurances.
●All accounts are to be reviewed for insurance or patient follow-up.
●Research and appeal denied claims Answer all patient or insurance telephone inquiries pertaining to assigned accounts.
●Set up patient payment plans and work collection accounts.
●Update billing software with rate changes Update’s cash spreadsheet, runs collection reports.
University of Texas MD Anderson Cancer Center Houston TX May 2008 – Jan 2016
Revenue Cycle Collections Representative
●Verified Insurance Information, including obtaining authorization, precertification, and coverage.
●Worked daily electronic rejection reports by correcting and rebilling rejected claims.
●Identify claims processing issues and notifying managers to avoid further claims processing delays.
●Managed the process of generating and mailing patient statements.
●Uses technical expertise to obtain insurance information, verify benefits, and secure authorizations.
●Performed AR follow-up and appeals on unpaid and improper paid accounts by working assigned AR aging reports.
●Responsible for resolving patient calls concerning their accounts by establishing payment arrangements, discussing payment options and screening for discount eligibility.
●Document clear and concise follow-up notes in system for each account worked.
Patient Financial Services Oct 2007 – May 2008
Billing/Collections Specialist
●Specialist of Customer Service performs all customer service and collection activities across the Revenue Cycle.
●Job duties include, but are not limited to, answering patient questions regarding statements, posting guarantor payments, setting up payment plans within our policies, researching and resolving issues with accounts that have been identified by patients, reaching out to appropriate departments to resolve any requests made by patients connecting patients with financial counselling department for charity screening, communicating patient balances, meeting collection goals as set by department, and providing excellent customer service for all of our patients. Must have knowledge of all areas of the Revenue Cycle.
●Communicate and partner with other areas of Ensemble and Revenue Cycle to resolve customer service issues. performs other duties as assigned.
Contact this candidate