Service Representative Administrative Assistant

JUANITA GRAHAM

**** ***** ******* ****** ********, AL 36610 251-***-**** ***********@*****.*** PROFESSIONAL PROFILE

Customer service oriented professional with strong leadership skills. Able to provide administrative support and function as the primary interface between the patient and the provider. Follow policies, procedures, and guidelines to assure consistent quality. Ability to discreetly manage large amounts of sensitive and confidential information.

Ultimate Medical Academy – HIPAA Essentials for Healthcare Professionals Certificate.

Video Communication Platform – Zoom.

Microsoft Office Applications – Word and Excel.

KEY QUALIFICATIONS

Medical Administrative Assistant Medical Terminology Medical Transcription Patient Processing Patient Registration Medical Records Management Check In Check Out Data Entry Release of Information HIPAA Compliance Medical Laws & Ethics CMS1500 Claim Form Billing Cycle Claims Appeal Process Medical Billing Knowledge Third Party Billing Medicare Medicaid HMO PPO Basic Coding Skills for ICD-10 & CPT Insurance Verification Anatomy & Physiology EDUCATION

Ultimate Medical Academy

Associate of Science Degree / Health Sciences – Medical Administrative Assistant, 2022 PROFESSIONAL EXPERIENCE

Alorica/OPTUM Pharmacy – Irvine, CA 12/2022 – 04/2023 Patient Care Coordinator - WFH AGENT (Contracted)

Handled inbound and outbound telephone calls

Adhered to HIPAA law and OPTUM Pharmacy procedures and policies

Provided excellent customer service to patients with Standardize Insurance, Medicare, and Medicaid

Process information and data concerning Medicare/Medicaid recipients with Part A, B & D

Inquiries regarding Medicare Advantage Plans, were transferred to the appropriate department

Review the medical claim CPT (diagnosis codes) to ensure that the prior authorization data was correct

EPIC EMR Software: verify the patients’ demographics, healthcare plan, medical provider, and billing data

Microsoft office: Word, Excel, Power point, Outlook and Teams: letters, spreadsheets, presentations, send/receive emails, chat and attend meetings on Teams

Insurance verification: confirm eligibility and medication coverage

EOB (Explanation of Benefits): review deductible, premiums, co-payment, and outstanding balance

Assisted patients with programs that offer co-payment assistance

Billing: prepared and setup new accounts for members, process invoices to be e-mailed to the Standardize Insurance Plans. Accept payments for co-payments and out of pocket expenses; credit/debit cards, and checks (ACH) Chickasaw Corner Stop – Chickasaw, AL 11/2018 – 12/2022 Cashier / Customer Service

Train new hires, exhibit leadership, and lead by example.

Work as part of a team and interact with diverse customers and staff members.

Follow policies as they relate to customer confidentiality.

Offer a positive customer experience through customer care and attention to detail. JUANITA GRAHAM, Cont.

Shipyard Café – Chickasaw, AL 11/2018 – 12/2022

Cashier / Customer Service

Manage the cash in the drawer and stay aware of the price of goods.

Serve as a keyholder and administer training to new employees.

Receive payment by cash, check, and credit and debit cards, maintaining all cash and receipts.

Perform necessary opening and closing procedures to assure efficient operation.

Provide consistent and outstanding customer service to ensure opportunities for repeat business. Renaissance Inn – Gulfport, MS 04/2015 – 02/2016

Front Desk Receptionist

Served as first line of customer service for the property.

Checked guests in and out, assigned rooms, and responded to guest questions on hotel services and other matters.

Answered incoming phone calls, took messages, and processed financial transactions.

Entered accurate data utilizing the hotel reservations system and kept work area organized. Wild Wings Station – Gulfport, MS 01/2015 – 04/2015 Cashier / Customer Service

Offered fast and friendly service, operated the cash register, and maintained the overall appearance and cleanliness in the restaurant.

Worked as part of a team and interacted with diverse customers and staff members.

Followed all policies as they related to customer confidentiality. Alorica Telemarketing / Verizon – Saraland, AL 03/2013 – 11/2014 Customer Service Representative

Answered inbound phones and reviewed accounts.

Accepted and posted payments and set up new accounts.

Shipped products to customers and performed estimates for trade in values. Kindred Healthcare – Mobile, AL 10/2008 – 03/2011

Receptionist / Housekeeping

Served as a direct point of contact and worked closely with patients with mental disabilities.

Submitted paperwork for approval of care and sent referrals.

Handled files and records, verified insurance coverage, answered inbound calls, and scheduled appointments.

Prepared rooms and assisted with physical therapy and range of motion exercises. VOLUNTEER EXPERIENCE

Alabama Medicaid Office – Mobile, AL 03/2013 – 11/2014 File Clerk

Prepared new files, eliminated outdated files, and completed routine searches for lost files.

Located and retrieved information from files in response to requests from authorized users.

Submitted paperwork, answered incoming calls, and verified insurance.

Dealt with data that was sensitive and confidential in nature. Women’s and Children Hospital – Mobile, AL 05/2003 – 12/2006 Volunteer

Took vital signs and assisted with intake efforts.

Scheduled appointments and answered inbound phones.

Sat with patients and provided companionship and encouragement.

Engaged individuals in activities and sensory stimulation to encourage positive reactions.

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