Allison Dumas

Manchester, CT

Summary Notes

Allison is a medical customer service professional offering over 5 years of HEDIS experience.

She has been responsible for supporting complex medical billing, claims, and maintaining professional relationships with clients to increase profitability.

She is an outgoing, positive team player that specializes in quality, speed, and process optimization.

She is available to interview given a 24-hour notice and can start the second week of May 2023.

Skills

Microsoft Office applications (Word, Excel, Outlook, and PowerPoint)

SAP

Typing 60+ WPM

Working knowledge of medical billing (ICD-9 and CPT codes) & Medical terminology

Expert knowledge of Short-term disability &medical claims

Accounts payables and receivables

Administrative support Customer Service skills and support

Data Entry

Estimating

Faxing filing

Payroll

Multi-tasker

Careful and active listener

Professional and friendly

Cash handling experience

Work Experience

Clinical Administrative Coordinator (HEDIS) January 2023 to April 2023

UnitedHealth Group Minneapolis, MN

Conducted claims research, determining correct service location or verifying member history.

Performed provider outreach, verified and confirmed provider demographics & medical record requests, both by telephone and in writing.

Requested medical records and performed follow up of requests within database tools.

Maintained HIPAA standards and confidentiality of protected health information; reported critical incidents immediately.

Customer Service Representative September 2021 to January 2023

Park N Fly Windsor Locks, CT

Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.

Responds to customer requests for products, services, and company information.

Answers constant flow of customer calls with minimal wait times.

Patient Service Representative June 2021 to September 2021

Hartford Healthcare South Windsor, CT

Took copayments and compiled daily financial records.

Assisted patients in filling out check-in and payment paperwork.

Balanced deposits and credit card payments daily.

Explained plans for treatment and payment options.

Reviewed daily care slips for doctors.

Used EPIC to schedule appointments.

Patient Experience Specialist September 2020 to March 2021

MTBC/ Meridian Medical Windsor, CT

Processed verbal and written inquiries related to physician services.

Answered questions and concerns regarding accounts.

Provided problem resolution and support internal and external customers including clients, patients, and third-party carriers.

Maintained acceptable/ baseline level of customer calls processed per week.

Verified patient eligibility.

Worked with contacts in various departments on patient billing and credit issues.

Requested backup documentation as needed to bill, rebill, or resubmit claims.

Completed correspondence responsibilities including written letter/forms and telephone contact.

Customer Service Representative August 2019 to December 2019

Bob’s Discount Furniture Manchester, CT

Provided primary customer support to internal and external customers in a fast-paced environment.

Recommended products and services to customers.

Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.

Member Service Representative July 2014 to August 2019

Administrative Assistant Hartford, CT

YMCA

Delivered excellent service to all members.

Performed basic administrative responsibilities.

Responsible for effective and efficient contact between members and staff.

Answered inquiries and provide information to the general public and YMCA members.

Ensured that the member service center conveys the mission, purpose, image, and core.

Hedis Specialist January 2017 to May 2019

Anthem via Execusearch Staffing Solutions Inc. Wallingford, CT

Facilitated annual HEDIS medical record collection and/or abstraction processes through successful implementation of target projects, such as large group medical record retrieval.

Managed over 50 customer calls per day.

Implementation of invoicing processes coordinated by remote access record retrieval, and specialized deep research assignments and other specific initiatives as identified and directed by HEDIS leadership.

HEDIS Customer Service Representative January 2014 to May 2016

Aetna via US Tech Solutions Inc. Hartford, CT

Provided administrative and telephonic support for a data collection project in a fast-paced environment.

Meet deadlines with the project.

Worked under the direction of the Lead assisting and fulfilling requests by contacting and corresponding with provider practices.

Education

High School Diploma Albert I. Prince Tech

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