Customer Service Administrative Assistant
Resume:
MARY REEDl
*********.******@*****.***
PROFESSIONAL SUMMARY
Excellent, written and verbal customer service skills advanced computer skills.
Thorough knowledge of SNV, HHA, OT, PT, and ST visits and how they are billed
Accurate accounting skills with ten-key by touch
Over ten years of medical terminology ICD-10 and CPT codes
Billing and collection procedures expert with thorough knowledge of Appeal's
Patient chart auditing ability
Thorough knowledge of DRG, UB04 and HCPC coding guidelines
Thorough knowledge of commercial and private insurance carriers and COB
Thorough knowledge of legal terminology, Discovery, Lexus Nexus, West Law etc.
Call Center Certificate
EDUCATION
Associate of Science: Business Administration,
Draughons Jr. College - Nashville, TN
Paralegal Certification: Law
Southeastern College Nashville, TN
Currently enrolled online in a Customer Service, Administrative Assistant, Microsoft and Excel to stay
aware of any changes or improvements within my field.
EMPLOYMENT HISTORY
2/2015 to present
Mac's Solutions
Preparing Contracts
Taking customer calls, making calls to customers
Keeping necessary records for the business
This was part-time and PRN.
Receptionist/Customer Service Rep - 01/2013 to 01/2015
AppleOne Employment Agency Brentwood, TN
I worked temporarily while I was married.
I worked doing Receptionist and administrative work, such as checking home loans for
completion, answering telephones, entering information into the computer and did basic office
work
Worked as a Customer Service Representative for Aetna
Office Team Employment Agency - 9/2014- 10/23/2014
I only worked one month for Office Team but worked consistent for AppleOne.
Worked at Tennessee Health Connection taking calls for insurance regarding TennCare,
Medicaid, Cover Tenn. etc., provided benefit information also how and where to apply
Patient Acct. Rep - 03/2012 to 07/2012
Pride staff Employment Agency Nashville, TN
Worked patient accounts and made adjustments, re-billed claims, filed appeals and medical
collections
Precisely completed appropriate Appeal's, documentation and system entry
Meticulously identified and rectified inconsistencies, deficiencies and discrepancies in medical
claims and patient accounts
Maintained updated knowledge of coding and billing requirements
Verified patients' eligibility and claims status with insurance agencies
Diligently filed and followed up on third party claims
Determined prior authorization for patient procedures
Researched questions and concerns from providers and provided detailed responses
Compiled and tracked outstanding balances owed to medical facilities
Prepared billing correspondence and maintained database to organize billing information
Medical Records Clerk - 11/2011 to 03/2012
Randstad Employment Agency-Nashville, TN
Sorted, filed and copied medical records and answered the telephone and filed medical records
Answered telephone and called on outstanding accounts
Team Lead/Receptionist - 11/2010 to 09/2011
American Esoteric Labs Nashville, TN
Billed all lab charges for Nursing Home's, Physician's and Clinic's
Collected on all facilities billed
Handled all correspondence and issues from the facilities and insurance companies
Answered all calls concerning billing and collections
Made corrections in DDE for Medicare claims and re-bill
Worked all Medicare, Medicaid and commercial insurance appeals
Handled all prior-authorizations when needed
Interviewer II - 12/2008 to 10/2010
Tennessee Department of Labor Nashville, TN
Interviewed unemployed claimants over the telephone to obtain necessary information to
determine eligibility for unemployment checks, according to the laws and guidelines of
Tennessee.
Explained and interpreted unemployment program guidelines and regulations to claimants
Entered all information needed on statements for Adjudicator's and completed all documents
necessary for their decision making process
Contacted employers to verify claimant work history, discharge or quit information Maintained
daily claimant information file for any required follow up
Traveled to other cities in Tennessee and took TRA federal claims
Customer Service Representative - 05/2008 to 07/2008
Cigna Government Services /Judge Temporary Service Nashville, TN
Worked in Medicare Customer Service Department, informing Durable Medical Equipment
Providers of how to bill their Medicare claims correctly
Answered questions about Medicare billing guidelines and regulations
Documented questions and answers on Excel spreadsheet
Administrative Paralegal - 06/2006 to 05/2008
Platinum Realty Nashville, TN
Prepared documents needed in property closing appointments.
Prepared files for each client or Realtor
Processed all office accounting
Talked to buyers and sellers about property listings
Administrative Paralegal - 09/2005 to 06/2006
Tennessee Department of Human Services Nashville, TN
Audited TennCare accounts for accuracy or fraudulent information
Prepared legal documents for TennCare hearings
Corresponded with claimants and Attorneys on TennCare
Contracts and hearings
Reimbursement Specialist - 02/2000 to 07/2005
DaVita Healthcare Brentwood, TN
Collected outstanding insurance balances on patient accounts and insurance Audited and billed
claims for payment corresponded with insurance companies about contract payment errors
Maintained running balances on insurance payments and payment retractions
Maintained Excel spreadsheet on all accounting transactions and insurance follow up
Verified insurance for coverage, deductible, out-of-pocket, in or out of network
Corrected patient accounts with billing and or payment errors
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