Customer Service Medical Records
Resume:
Chevonia Smith
San Antonio, TX *****
***************@*****.***
Authorized to work in the US for any employer
Work Experience
Customer Service Representative
3M-San Antonio, TX
November 2022 to Present
Analyze and prioritize orders based on initial assessment of documentation and customer outreach
● Verify third party payer benefits and eligibility (online or telephonically).
● Review and analyze payer specific requirements and coverage criteria to determine required documentation and accurate billing criteria.
● Conduct in depth review of clinical documentation (medical records, prescriptions, operative reports, history and physicals) based on billing criteria.
● Call customer or field personnel to obtain missing documentation required for placement and/or billing.? Could include home health agencies, patients, hospital/facilities, physicians.
● Contact patients to coordinate delivery of product.? Communicate the patient's financial responsibility and any special instructions.
● Follow-up post-delivery to obtain any additional documentation to support billing criteria.
● Prioritizes and executes based on customer and/or business urgency.
● Provides a high level of customer service in a competitive market.
● Acts as a resource for Sales and other cross functional departments to provide order status and any other information.
● Participates in all reasonable work activities as may be deemed suitable and assigned by management.
● Conforms to, supports and enforces all Company policies and procedures.
● Build support and maintain patient, physician, and third-party payer loyalty and to increase the number of orders through enhanced customer services, customer relationship management, and technology utilization.
● Requires repetitive keyboarding over 95% of the time and phone usage 60% of the time Medical Clerk/Receptionist
TekWissen Group-San Antonio, TX
February 2021 to November 2022
- Assisted with scheduling and cancelling appointments daily for 25 Tricare members
- Scanned in patient medical records into electronic medical records systems
- Provided exceptional customer service and problem solving techniques in an attempt to further the patient's health and overall well-being.
Medical Clerk/Receptionist
Case healthcare solutions-San Antonio, TX
January 2019 to January 2020
Receives incoming requests for information and responds to requests by opening mail, assisting walk-ins and telephone inquiries, and retrieving facsimile inquiries in a timely manner.
• Date stamps all requests and highlights pertinent data to facilitate processing.
• Validates requests and authorizations for release of medical information according to established procedures and
HIPAA guidelines.
• Completes release of information requests including retrieving patient's medical charts and returning charts, copying/scanning medical records accurately and correctly, according to requests,
established procedures, and established standards of quality and productivity; and electronically transmits medical record to processing
operations.
• Performs quality checks on all work to assure accuracy of the release, confidentiality, and proper invoicing.
• Maintains equipment in excellent operating condition (inside and out) and troubleshoot equipment issues with assistance from the Help Desk department.
• Provides excellent customer service by being attentive, respectful and professional at all times; insures understanding of customer request and follows-through as promised; being proactive in identifying and addressing member concerns, or problems.
• Demonstrates helpful and effective telephone etiquette and customer service skills by providing appropriate information to callers.
• Maintains a neat, clean, and professional personal appearance and observes the dress code established by the Company or the member facility.
• Maintains a clean and orderly work area, insures that records and files are properly stored before leaving area, and insures adequate supplies to meet customer requests.
• Maintains working knowledge of the current state laws regarding fee structure, and HIPAA regulations as well as facility policies and procedures in regards to release of information.
• Ability to maintain regular attendance and punctuality as scheduled. Notifies Manager, Operations and/or Supervisor if unable to adhere to daily schedule.
• Adheres to all Company time and attendance policies or applicable law covering meal breaks and rest periods. Records all accurate work hours in the Company's designated time keeping system daily and adheres to the Company's overtime policy and procedures for requesting time off or change in schedule.
• Works within scope of position and direction; willingly accepts assignments and is available to take on additional member facilities and assist with ROI backlogs.
• Performs responsibilities in accordance with the Company's and member facilities policies and procedures and state and federal labor regulations and works to minimize confidentiality breaches. • Maintains confidentiality, information security and ethical behavior when handling all Company and medical records information during transport, storage and disposal. Will not remove medical records information from member site unless written authorization is provided by the facility's HIM Director, Company Manager and/or Supervisor and Vice President of Operations.
• Attends and participates in required educational training sessions and staff meetings as scheduled and assigned.
• Ability to adapt to change and respond to difficult and challenging situations in a professional manner. • Accepts new assignments willingly to meet business needs.
• Communicates with Manager on an on-going basis, providing information and data as requested including
member's changing needs and requests.
• Promptly reports to Manager any customer service concerns and/or any potential HIPAA violations whether actual or perceived.
• Informs Manager of site or work difficulties, special project requests from facility, and fluctuating volume in daily
workload. • Ability to accurately and efficiently utilize a computer for data input, retrieval of data and all other tasks associated with release of information services and time reporting.
• Ability to work with minimum supervision, organize workload and prioritize work tasks to meet production goals.
• Ability to recognize emergency situations within context of job duties and communicate potential issues to Supervisor
and/ or Manager, Operations.
• Maintains knowledge of safety procedures to ensuring a safe work environment and reports safety concerns to
Supervisor and/or Manager, Operations
• Maintains a current and valid driver's license and insures personal automobile insurance is in force and will be maintained, in at least the amounts required by state law, on any automobile or transportation that is use in connection with Company duties.
• Checks the Company's and other assigned email and communication systems such as REP Online and member
assigned email on a daily basis. Utilizes assigned tools within established guidelines. Performs other tasks as assigned including but not limited to working at facilities within 50 miles of principal site as business needs arise.
• Adheres to the Company's Code of Conduct and business standards. temp company- Medical Case Specialist
Insight Global
August 2018 to January 2019
- Answering phone calls
- Verify appropriate CPT and CLIN codes are assigned to each case.
- Obtain medical history for specific conditions.
- Determine appropriate examinations, tests and specialist required for each case. Medical Clerk/Receptionist
Dependable Health Services-San Antonio, TX
October 2016 to October 2018
Wilford Hall Ambulatory Surgical Center
Medical Administration Tech
- Assisted with scheduling and cancelling appointments daily for 25 Tricare members
- Scanned in patient medical records into electronic medical records systems
- Provided exceptional customer service and problem solving techniques in an attempt to further the patient's health and overall well-being.
Medical Clerk II
Healthcare Resolution Services
June 2013 to October 2016
Assigned codes to documented patient care encounters (inpatient or outpatient) for one or more specialty and subspecialty health care services provided by the VA Medical Center.
- Utilized the facility computer system and software applications to code, abstract, record, and performed a comprehensive review of the patient record to abstract medical, surgical, ancillary, and demographic, social, and administrative data to ensure complete data capture
- Assisted facility staff with documentation requirements to completely and accurately reflect the patient care provided; provides technical support in the areas of regulations accepted nomenclature, and proper sequencing
Education
Bachelor's degree in Health Information Management Southern New Hampshire University-Manchester, NH
June 2021 to December 2024
Graduated with Bachelor's Degree in Healthcare Information Management. Skills
• Strong knowledge of window, word, and excel operating systems
• Computer Networking
• Financially accountable for patient's deductible, co-pays, and out of pocket expenses
• Informatio n Security DoD Customer Experienc Service e Customer Operating Care Systems Call Center
• Microsoft Windows
• Over 4 years of working for Department of Defense and Veterans Affairs (VA)
• Patient Account Training Certified
• Type 40 WPM
• Medical Records
• 20 years customer service experience
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