Summary

Looking to secure a position in financial services and/or accounting, in which I can apply my professional experience, training, and attention to detail.

Education

Liberal Arts

Oakcrest High School • Mays Landing, New Jersey

06/1987

Experience

Patient Services Representative

Children's Hospital of Philadelphia • Philadelphia, Pennsylvania 09/2022 - 10/2022

- Greeting and directing patients to examination rooms.

- Scheduling patient appointments and making reminder calls.

- Informing patients about delays and waiting times.

- Updating and verifying patient information at every visit.

- Assisting patients in filling out patient history forms, consent forms, and payment contract forms, when necessary.

- Answering, investigating, and/or directing patient inquiries or complaints to the appropriate medical staff member.

- Following up with patients to ensure their inquiry or complaint has been satisfactorily resolved. Customer Care Specialist

Penn Medicine University City • Philadelphia, Pennsylvania 12/2021 - 06/2022

Demonstrates ability to successfully adapt and perform during times of high volumes and/or high patient acuity. Demonstrates skill to service both hospital and physician office patients, as assigned. Supports inbound and outbound calls to or from patients, guests, or appropriate parties to provide services. Effectively manages general patient complaints/concerns in a professional manner, escalating more complex issues to supervisor/manager as needed.

Understands and supports Point of Service Collections. Performs all necessary functions needed to collect patient obligations.

Verifies patient, guarantor, coverage and hospital account information. Performs required referral/authorization processes and enters orders for applicable tests.

Understands insurance company coverage and referral/authorization requirements of payors. Performs electronic and manual verification of insurance coverage and understands how to read and accurately apply electronic insurance responses.

Gary Bragg

5506 Master St, Philadelphia, PA

adzmo3@r.postjobfree.com

267-***-****

Completes documentation for compliance and regulatory needs and/or release of orders. Retains knowledge and abides by all regulatory requirements pertaining to duties of position and overall operations (as applicable). Screens and accurately relays messages using protocols established for emergent, urgent and non-urgent calls. Demonstrates ability to register unscheduled patients requiring a full financial clearance. Completes assigned patient scheduling and registration work queues according to performance standards. Ability to resolve work queue issues and missing registration items via electronic medical record. Billing Representative

BioTelemetry • Malvern, Pennsylvania

07/2020 - 05/2021

- Entering demographic and charge information to bill claims to payors.

- Verify insurance eligibility via online portals.

- Follow up with practices/patients via phone or fax for missing information.

- Identify and bring reoccurring issues to the attention of leadership. Follow internal processes as well as meet or exceed monthly quality and productivity standards. Adhere to Reimbursement Standards and Expectations Denials and Appeals Specialist

WellMed • Newtown Square, Pennsylvania

09/2019 - 01/2020

Responsible for insurance claim denials, rejections and resubmission of claims.

- Review all pertinent information, i.e; EOB, denial letters and electronic remits to analyze claim denials in order to perform the appropriate appeals necessary for reimbursement.

- Accesses, utilizes and discloses Protected Health Information (PHI) according to department policies and HIPAA regulations..

- Tracks and documents all denials by insurance carrier, visit type and denial category. Works with the insurance carrier to understand specific reasons for denials and preventable measures available to prohibit future denials. Member Service Representative

AmeriHealth Caritas • Philadelphia, Pennsylvania

11/2018 - 09/2019

- Responding to a diverse membership and provider scope, including inbound/outbound member and/or provider phone calls or correspondence regarding benefit, eligibility or customer issues.

- Provides member education and assists members with PCP selection and assignments with SAP monitoring.

- Assists with access to care and wellness program.

- Follows internal processes and procedures to ensure all activities are performed in accordance with departmental and company policies and procedures.

Call Center Card Services Representative

Bank of New York Melon • King of Prussia, Pennsylvania 03/2017 - 07/2017

- Resolve customer disputes such as unauthorized card transactions, merchant processing disputes, authorization declines and ATM discrepancies with SAP monitoring.

- Troubleshoot and resolve Check Card processing issues with emphasis on customer service.

- Follow policy and procedures to reduce financial losses due to regulatory fines and/or customer errors.

- Work directly with BNY Mellon's Fraud Prevention and Investigative Services to minimize and mitigate potential loss. Medical Billing Specialist

Crozer Health • Chester, Pennsylvania

10/2016 - 12/2016

- Answer a high volume of calls from patients or their representative, regarding patient bill balances, payment plans, credit card payments, patient pricing, rebilling insurance companies and general customer concerns

- Process adjustments, refunds, transfer bills, mail returns and perform manual sales

- Evaluate and respond to all aspects of written billing inquiries, including but not limited to: billing insurances, and updating invoices

- Research, troubleshoot and resolve complex billing issues and customer complaints, taking all steps to resolve and ensure full resolution

- Maintain tracking log of all escalated patient correspondence, providing status updates to leadership as needed Deposit Operations Specialist

Ally Financial • Fort Washington, Pennsylvania

06/2009 - 12/2015

- Create customer account adjustments due to processing errors on behalf of our bank or a forward clearing bank

- Support Deposit Operations and Accounting with the clearing and posting of rejected items associated with the Debit Card, ACH, Bill Payment, and Checks

- Customer contact regarding complex or detailed explanations and or descriptions of transactions as required

- Prepare a variety of debit and credit transactions to accomplish necessary corrections or adjustments, process customer interest checks, perform deposit verifications, prepare reports, perform account maintenance review, review and mail account notices and account statements

Skills

Customer service, Computer skills, Communication skills, Medical office experience Languages

English

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