Business Development Customer Care
Resume:
Edna Webb
************@*****.***
Conley, GA ****8
Results oriented medical professional with expertise in driving financial health and business development.
Exceptional people skills with strengths in ensuring high customer satisfaction and consistent revenue growth.
Possesses proven ability to succeed, excellent leadership skills and superb communication and interpersonal abilities.
Work Experience
Customer Care Associate WellSpark/ConnectiCare - Connecticut August 2022 to January 2023
•Processed forms, non-compliances reinstatements, uploaded labeled and verified documents received by email, fax or regular mail. Adhered to HIPA Rules and Regulations non-disclosure of information without consent,
•Handled 30-60 calls per day as well as 15-30 call backs, conferenced with ins company, assisted with doctors in-network Used multiple systems to include outlook, teams, conifer, genesys cloud,panviva Lexisnexis Salesforce.
•Assisted with Hep portal logins and creating accounts, verifying and entering data. Notating dates of service and proofreading documents, Communicating with clients via email phone postal mail or fax,
•interacts with customers to verify, provide information in regards to responses to Hep requirements to include dates of service, demographic information fix this- feature preventive, and chronic questionnaires
•Handle and resolve complaints, or refer complex matters to mentors for further review
Iconma- Contractor Treasury Banking Specialist
Bank of America - Kennesaw, GA January 2020 to October 2020
•Reviews verifies and/ or identifies customer transactions to detect/ prevent financial crime activity. Troubleshoot investigate and resolve fraud issues for atm, debit card, lockbox, Payroll Cards, ACH clients.
•Supported new account implementations and assisted with Treasury integration projects
•Gathers info from client to submit fraud claims or billing dispute. And issue credits. Close and reissue debit and atm cards due to suspicious activity or charges client didn't make or don’t recognize. Verify signature cards on business accounts. Customer service inbound and outbound calling. Authenticate all accounts.
•Providing customer service through inbound call queue, for retail Bank Accounts, Loans, Debit Cards, and Internet Banking. Processing Time Deposit accounts, Wires, Opening and Closing CD's. Electronic Banking for Treasury Team processing ACH payment in the nacha system.
•Use a variety of sources for information to include online systems and tools such as model, flash boss synergy and solution center, Reissue lost stolen damaged or cards not received. Add blocks to prevent charges due to fraud, Read disclosures to client after claim or billing dispute has been created.
•Remove restrictions from cards once charges are made valid and have been identified by the client,
•Monitors moderate to complex account activity which requires research that involves multiple transactions.
Assurant Contractor Property Claims Rep
Manpower - Marietta, GA
July 2019 to September 2019
•Forwarded suspected fraudulent and questionable claims to appropriate personnel.
•Answering incoming customer calls and provide appropriate level of service and issue resolution.
•Receive and answer customer questions and resolve concerns relating to claims warranties and product servicing
•Appropriately escalate customer questions and issues according to company guidelines
•Assess client needs and resolve claims according to insurance policy provision submitting new claims.
•Coordinate with immediate supervisor and field or claims adjusters as needed to resolve customer issues.
Contractor Medical Billing Representative
Robert Half - Sandy Springs, GA December 2018 to March 2019
•Submitted medical claims to insurance companies and payers such as Medicare and Medicaid. Refunds
•Collects delinquent accounts by establishing payment arrangements with patients: monitoring payments, following up with patients when payments lapses occur. (ECW and EPIC system) answer email request. Proof of payments.
•Utilizes collection agencies and small claims court to collect accounts by evaluating number of statements and payment history on accounts. Assisted patients in six markets, Working with AR reps to ensure accuracy
•Maintain bad-debt cost report by tracking billings: monitoring collections compiling information.
•Taking credit card payments. Trouble shooting accounts to resolve billing issues. Posted payments.
Unit Secretary
Pro Staff -Hugh Spalding Hospital - Atlanta, GA February 2017 to May 2018
•Assisted house supervisor with patient transfers to psychiatric facilities. Entered Time and Attendance, Assisted with payroll submittals. Prepares and maintain paper and computerized medical records, census and admission logs.(EPIC system)(Responder5)
•Assisted entire medical staff with administrative needs to include faxing coping dictations, baby wellness appointments, transcribed and entered doctors' orders, prepared staff assignments in tele tracking system
•Served as primary contact for emergency awareness for staff and patients, initiated group huddles, monitored door entrance by camera and lock button, by adhering to HIPA rules and regulations.
Research Behavior Health Data Entry Analyst
Pro-Staff/ Marcus Autism Center - Atlanta, GA August 2016 to December 2016
•Verifies entered data by reviewing, correcting, deleting, or reentering data; combines data from multiple systems protecting patient information by adhering to HIPA rules and regulations.
•Purge files to eliminate duplication of data. DEX, CERNER, EPIC)
•Follows data entry requirements and procedures data extracting adheres to center operations by following all additional policies and procedures, SAP,ERP
•Monitored feeding and potty sessions. Collaborating results from customer call backs to physicians and psychiatrists
CHOA Aflac Cancer and Blood Disorders Center Registration Coordinator Contractor
Pro Staff - Atlanta, GA April 2016 to June 2016
•Scheduled and set appointments when needed reported cancellations and referrals from faxes .prioritized fast track and deep sedation patients. EPIC system)
•Conferred with nurses and physicians to resolve discrepancies, verified all insurance coverages.Processed cash,cc,and check payments.
•Obtained demographic, diagnostic, and epidemiologic treatment and survival patient information from inpatient and outpatient reports medical records and electronic data bases, Pre Authorization / referrals
Customer Service Representative
Medworx LLC - Ruleville, MS November 2014 to November 2015
•Collections computerized adjustments, researched accounts, uploaded documents, sold pain creams and prosthetics.
•Data entry obtained and posted credit card payments through QS-1 system. Adhered to HPPA guidelines and regulations copied and uploaded important documents to be further processed. Inbound and outbound calls.
•Assigned mandatory continuing education courses, networked at events to drive business development.
•Conferenced with different insurance companies and doctors' offices for eligibility and cancellation purposes to insure proper healthcare coverage. Assisted with prior authorizations when insurance rejected claims.
Administrative Data Analyst
Kelly Service - Delray Beach, FL April 2009 to October 2014
•Organized and evaluated statements vendor contracts, and EHR system project scheduling
•Guiding Care identified gaps i ben care enhanced quality and compliance engaged patients as well as members. Interfaced with EMR systems supporting 30 health plans Coding procedures
•Assisted Care Management team of 9 with proper facility placement timelines and insurance approvals for service rendered.
•Researched and tested data entered 84 claims per day downloaded to other sources to be evaluated and processed. Medical billing Implemented plans for patients with chronic or complexed conditions to manage their health.
Education
Certified Professional Coder in Medical Billing and Coding
Everest College - Hampton, VA August 2009 to May 2010
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