Customer Service Full Time

Eva Moore 214-***-**** or 469-***-**** ~***************@*****.***

Professional Profile & Skill Set Summary

Excellent diverse background in Credit & Collections, Administration, Customer Service, and Medical Insurance Billing

and Coding, the ability to utilize good time management and organizational skills; results oriented, confident in making

on-the-spot decisions as well as possessing strong interpersonal skills; able to work well with diverse groups.

Computer literate with the ability to utilize technology within a fast pace business environment

Knowledge and experience with: Microsoft Word / Excel / Access and PowerPoint / Med iSOFT Medical Office Software

Professional Employment History

Steward Healthcare) – Dallas, TX August 2015 – October 2022 (Revenue Cycle)

Insurance Verification (with prior authorization and referrals)

Commercial Specialist, Medicare Supplement/Replacement & Medicaid

Inbound to outbound, contact insurance groups and/or patients, and online verification

Request credit balances and issue refunds upon request

Methodist Urgent Care – Richardson, TX August 2014 – February 2017

Patient Services Representative (PSR Full-Time)

Responsible for patient Check-In and Check-Out

Scheduling, Insurance Verification, Batch Reporting, Financial Reporting open to close

Benefits, eligibility, deductible and coinsurance, payment, and postings

HealthSmart February, 2011 – October, 2014

Customer Service Advocate (Provider Relations & Claims Repricer)

Assist affiliated states with delegating groups, conduct provider education on HealthSmart policies and procedures,

programs, products, and operational workflows; assist provider with escalated service issue resolution and free dispute

resolution.

Handle telephone inquiries in a timely and accurate manner to provide courteous and efficient service to callers

Document all phone activity in a clear manner, interpret and communicate contracts, agreements, or benefit and claim

information utilizing a online system; adjust individual work flow to ensure that all department goals are met

Reprice facility and professional claims according to network contracted rates

Adhere to all HIPAA rules and regulations

Dr. Dalphne Favroth (Internal Medicine & Pediatrics) April, 2009 – September, 2011

Personal Assistant

Was responsible for front and back office; office referral coordination, insurance verification for Medicaid and Medicare

and commercial insurance; interacted directly with drug reps; ordered supplies and set up meetings for the doctor.

Duties also included; marketing and advertisement for this Family Health & Wellness Clinic

Medical Edge Healthcare October, 2007 – February, 2009

Billing/Registration Specialty Clerk / Hospital /Home Health Hospice Care

Registration of face-sheets with or without demographics, billing detail for non-commercial or commercial insurance

Detail accuracy for patient information and updated old and/or new accounts

Intracorp Cigna Health Care October, 2003 – February, 2005

Contractor(with prior authorization)

Was responsible for in-bound and out-bound calls providing customer service responding to a variety of Medical –

professionals and customer relations; pre-determination of insurance qualifications

Education & Training

Collin County College 2011- present

Richland College – Dallas, TX 2012- present

Medical Coding/Billing

Contact this candidate