Customer Service Medical Office
Resume:
Kenga Jackson
Hampton, VA *****
******************@*****.***
Professional Summary
Results-driven customer service professional with 10 years of experience in the healthcare industry, specializing in patient advocacy and medical office operations. Proven track record in managing patient communications, resolving billing issues, and ensuring compliance with HIPAA protocols. Skilled in utilizing EPIC software for efficient patient account management and fostering strong relationships with insurance providers. Committed to delivering exceptional service and support to enhance patient experiences.
Work Experience
Approval Specialist
Patient Advocate Foundation-Hampton, VA
October 2024 to May 2025
Answered incoming calls and collected patient information.Educated approved patients on the program guidelines which included verification of diagnosis and the requirements for claim submission process and income verification
• Provided exceptional customer service and support to ensure customer satisfaction
• Resolved customer inquiries, complaints, and issues in a timely and professional manner
• Maintained a high level of product knowledge to effectively assist customers with their needs
• Managed a large volume of incoming calls and emails from customers, addressing their concerns and providing accurate information
• Built strong relationships with customers through effective communication and personalized interactions
• Collaborated with cross-functional teams to resolve complex customer problems and escalations Medical Office Assistant
Riverside Ophthalmology Associates-Hampton, VA
June 2019 to October 2024
• Used EPIC software to process patient payments and update accounts.
• Scheduled patient appointments and cultivated partnerships with managed care organizations, hospitals and insurance carriers to ensure swift payment and issue resolution.
• Maintained confidentiality of records relating to clients' treatment
• Collected information, verified insurance and collected co-payments for patients each day.
• Assisted with referrals and prepared medical records for patients.
• Collected forms, copied insurance cards to coordinate patient information for billing and insurance processing.
• Scheduled appointments for patients via phone and in person.
• Ensured patient confidentiality in alignment with HIPAA protocols.
• Cooperated with Medicare, Medicaid and private insurance providers to resolve billing issues.
• Registered patients and scheduled appointments.
• Maintained accurate electronic medical records (EMR) for all patients, including updating personal information, medical history, and treatment plans
• Managed patient scheduling and appointment coordination, ensuring efficient flow of daily operations
• Performed administrative tasks such as answering phone calls, responding to inquiries, and managing correspondence
• Coordinated referrals to specialists and scheduled necessary diagnostic tests for patients
• Verified insurance coverage and processed billing information accurately to facilitate timely reimbursement
• Provided exceptional customer service by addressing patient concerns or complaints in a professional manner
• Collaborated with healthcare providers to ensure seamless communication between the office staff and clinical team members
• Implemented efficient filing systems for organizing patient records both electronically and physically
• Assisted in training new office staff on administrative procedures and protocols
• Maintained strict confidentiality of patient information in compliance with HIPAA regulations at all times
• Scheduled follow-up appointments for patients based on physician recommendations or treatment plans
• Ensured cleanliness of waiting area, reception desk, examination rooms, and other common areas
• Collaborated with insurance companies to verify coverage eligibility prior to appointments or treatments
• Assisted in the coordination of laboratory tests or imaging services ordered by physicians
• Maintained knowledge of medical terminology to effectively communicate with healthcare professionals
• Managed patient billing and payment processing, including insurance claims and collections
• Assisted in the implementation of electronic medical record (EMR) systems to improve efficiency and accuracy of documentation
• Provided administrative support to physicians during patient consultations or meetings VA Claim Customer Service
Healthnet Federal Services-Hampton, VA
October 2018 to January 2019
Communicated claim status and information concerning the filing for services provided on behalf of the Veteran Administration
Authorization and Appointing Representative
Healthnet Federal Services-Hampton, VA
April 2016 to September 2018
• Entered specific data/information from Veteran's Administration and veterans into the authorization system achieving required quota/quality standards
• Assisted Veterans with scheduling and rescheduling and obtaining required authorization for services needed and rendered with non-VA providers
• Located providers, set the appointment and notifies the Veteran of the upcoming appointment
• Provided general customer services and provider changes when requested PC3 Appointing Representative
Healthnet Federal Services-Hampton, VA
February 2014 to April 2016
• Received Authorizations from the VA and contacted patients to determine the patients needs in order to set an appointment
• Located providers within approved distance and scheduled and confirmed appointment time and procedure to be provided
• Collected medical notes from the provider and forwarded to VA Education
High school or equivalent in General diploma
Bay Ridge High School-Hampton, VA
September 1979 to June 1983
Skills
• English
• Office experience
• Microsoft Office
• Insurance eligibility verifications
• Billing and coding
• Strong interpersonal skills
• Typing
• Mail management
• Patient charting
• Time management
• Microsoft Word
• Organizational skills
• Professional and mature
• Front desk
• Medical terminology
• Customer service
• Results-oriented
• Meticulous attention to detail
• Strong problem solver
• Microsoft Excel
• Phone etiquette
• Data entry
• Resourceful
• Excel spreadsheets
• Claims appeal procedures
• Computer skills
• Medical office experience
• Self-starter
• Report writing
• Microsoft Office proficiency
• Proofreading
• Dedicated team player
• Understands grammar
• Self-directed
• Microsoft Outlook
Certifications and Licenses
CPR Certification
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