DONNA FLINN

Pitman, NJ *****

adylbi@r.postjobfree.com / 609-***-****

SUMMARY

Dedicated Customer Service Specialist providing skills to prioritize and multi-task in fast-paced working environment. Successfully works as part of team to reach personal and business goals. Known for successfully handling escalated customer support issues. And always providing a 'five star'customer service experience. SKILLS

Medical Terminology

Excellent time management skills

Medical Billing

Prior-Authorization

Durable Medical Equipment/Home healthcare

coordinator

Take initiative in keeping current in my position by asking questions, accepting all forms of feedback

and reviewing error sources to prevent denial of

claims

Customer Service

Office Equipment Proficiency

Problem-Solving Abilities

Computer Proficiency

EXPERIENCE

Healthcare Customer Service Representative / RCI Industries - Woodbury, NJ 11/2019 - 06/2023 Confirm client insurance eligibility

Update to current client demographic information in EMR. Obtain all required documents to submit to insurance carriers to initiate Prior-Authorization process Follow up with authorization requests regularly.

Communicate status with clients, team members and other stakeholders. Handle a high volume of inbound communication via telephone, email, fax and chat Provide each client with a higher than industry standard level of customer service Able to utilize several computer systems/double monitor Prior-Authorization/DME Coordinator / Regional Surgical Associates - Voorhees, NJ 09/2017 - 11/2019 Communicate any co-pays or out of pocket expenses to patients prior to rendering medical procedures Coordinated resolutions for issues and appealed denied authorizations. Performed detailed medical reviews of prior authorization request, following established criteria and protocols. Applied knowledge of Medicare, Medicaid and third-party payer requirements utilizing on-line eligibility systems to verify patient coverage and policy limitations.

Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients. Notified ordering providers of denied authorizations. Maintained files for referral and insurance information, entering referrals into system. Scheduled patient appointments, diagnostic specialty appointments, tests and procedures. Updated reference materials with Medicare, Medicaid and third-party payer requirements, guidelines, policies and list of accepted insurance plans.

Clarified patient inquiries and questions to update patient account information in computer system. DF

Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.

Provided accurate information to all parties, including patients, insurance providers, healthcare staff and office personnel by using effective written and verbal communication skills. Identified reasons behind denied claims and worked closely with insurance carriers to promote resolutions. Determined which party would be liable for payment on medical services by thoroughly reviewing patient insurance coverage.

Adhered to HIPAA requirements to safeguard patient confidentiality. Communicated with patients with compassion while keeping medical information private. Prepared reports, invoices, letters, or medical records using word processing, spreadsheet, or other software applications.

Compiled and coded patient information or data in appropriate computer system. Transcribed recorded practitioners' diagnoses and recommendations into medical records. Member Service Representative / Cigna Health Springs - Philadelphia, PA 07/2015 - 09/2017 Handle customer inquiries in a prompt and professional manner Remain positive in a fast paced environment

Operate PC's to type, navigate the internet,

Excellent oral and written communication skills

Ability to multitask and prioritize work in high volume environment Identify escalating priority issues, report to higher level of management Managed customer conflicts and challenging situations by staying calm and accessing internal knowledgebases to develop strategic solutions.

Helped members resolve account problems and navigate internal systems to handle routine needs. Presented and explained services and products to meet member needs. Leveraged software and systems to research and resolve member inquiries. Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service. EDUCATION AND TRAINING

Associate of Science: Nursing Administration 08/2000 Gloucester County Institute of Technology - Sewell, NJ High School Diploma 06/1988

Clayton High School - Clayton, NJ

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