Customer Service Medical Billing

DAVID GOMERINGER

***** ******* *** ***** ******, TN 38368 707-***-**** ***************@*****.***

PROFESSIONAL PROFILE

Customer service oriented professional, able to provide timely and accurate data to ensure reimbursement for patient services. Follow policies, procedures, and guidelines to ensure consistent quality. Maintain and assure patient privacy and confidentiality.

Ultimate Medical Academy – HIPAA Essentials for Healthcare Professionals Certificate.

Consistently model and inspire high levels of integrity.

Actively participate in learning opportunities and adapt to new environments.

Attention to detail needed to maintain high levels of accuracy.

Communication Platforms – Zoom, Skype, and MS Teams.

Microsoft Office Applications – Word, Excel, Outlook, Access, and PowerPoint Type 40 WPM.

KEY QUALIFICATIONS

Medical Billing Accounts Receivable Collections Co-Pay Deductibles Co-Insurance EOBs

Revenue Cycle Management Posting Payments Government (Medicare & Medicaid) Third Party Payers

Electronic Health Records (EHR) Electronic Medical Records (EMR)

Managed Care (HMO PPO POS) Workers Compensation Insurance Verification Insurance Claim Processing

CMS 1500 CMS 1450 (UB-04) Front Office Operations Medical Office Procedures Scheduling Medical Terminology Anatomy & Physiology HIPAA Compliance Medical Coding (ICD-10-CM HCPCS CPT) Microsoft Authenticator Duo Mobile Genesis Microsoft Teams Note pad + Note pad ++

EDUCATION

Ultimate Medical Academy Diploma – Medical Billing and Coding, 2023

PROFESSIONAL EXPERIENCE

First Source – Remote Reagan, TN (Work from Home) 09/2022 – 10/2024

Member Service / Provider Service

The systems used were Sentara, Genesis, VPN, Duo and Microsoft Authenticator.

Answered inbound calls and made outbound calls to providers when needed for a member’s case issue.

Used online based systems that allowed access to Authorization lookup, NPI search tools, Insurance lookup and transportation information for MBR’s of Molina Healthcare.

Assisted members to find transportation, get replacement ID cards for their insurance plans, find doctors in their area that are in network, Coordination of benefits, and submitted complaints of the services provided to the member.

Spoke with providers to assist with insurance issues for billing and or medical purposes.

Updated member demographics for contact information.

Adhered to HIPPA guidelines as outlined in employment contract.

Explained benefits to members and answered questions on insurance benefits that members had access to.

Explained provider benefits to providers with questions of authorization limitations.

Kept management informed on issues of members with grievances while assisting the members with their grievances and deescalated the members issues and resolved them.

Electronic Express – Jackson, TN 09/2021 – 08/2022

Retail Sales Associate / Customer Service

Train employees and provide excellent customer service with active listening to determine customer needs.

Interact with customers, sell and upsell merchandise, answer questions regarding products, recommend, select, and help locate best product to match customer needs, and assist with financing options.

Answer inbound calls, take inventory, order merchandise, operate cash register, scan merchandise, accept payments, and ensure accuracy of cash drawer.

Safeguard private information and work as part of a team and interact with diverse customers and staff members.

DAVACO – Irving, TX 09/2022 – 02/2023

Merchandiser

Made store visits for a set territory of retailers to ensure merchandising coverage goals were met.

Consulted with management in a timely manner, met objectives and goals as assigned, and reported store level observations related to client product and customer needs.

Built displays and placed promotional materials as outlined in instructions to ensure product promotions.

Operated machinery in a safe manner and completed detailed call notes and uploaded photos of completed work.

Door Dash – Crescent City, CA 02/2020 – 09/2022

Independent Contractor / Delivery Driver / Customer Service

Answered inbound calls and delivered high quality customer service as an independent food delivery driver.

Ensured timely delivery to build brand loyalty, processed payments, and followed procedures.

Worked independently in a minimally structured environment.

Remained flexible, calm under pressure, and dependable.

Walmart – Crescent City, CA 08/2017 – 01/2020

Asset Protection Customer Host

Patrolled store and monitored customers and security systems to prevent damage and theft.

Used radio to communicate with coworkers and identified and confronted potential shoplifting offenders.

Communicated effectively to interview suspects and witnesses to gather incident details.

Worked with various law enforcement agencies when necessary.

Documented security violations and observations in an accurate and thorough manner.

Private Duty Care – Crescent City, CA 08/2016 – 05/2017

Caregiver

Provided companionship and personal care.

Assisted with personal hygiene, feeding, and mobility needs.

Handled light housekeeping duties, prepared meals, and transported to locations outside the home to run errands to take to doctor appointments.

Ensured privacy of sensitive and confidential information.

Prior work history includes experience as a Chef / Dietician/ Certified Nursing Assistant at Addie Meedom House, a Transportation Security Officer at Transportation Security Administration and a Retail Pharmacy Cashier at Walmart

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