Customer Service Front Office

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KRYSTAL OGLE RESUME JANUARY 2023.doc

Krystal Ogle Cont.

Krystal Ogle

Address 85 Logan Street Old Fort, NC 28762

Contact 828-***-**** ***********@*****.***

PROFESSIONAL PROFILE

Top performing professional who combines strong academic success with cross-functional customer service experience to illustrate value. Backed by 11+ years of hands-on healthcare industry experience and accustomed to handling confidential information. Support the physicians and clinical staff with administrative functions of the front office.

·Attentive to Detail: Review and correct errors and maintain compliant documentation.

·Front Office: Verify insurance coverage, schedule appointments, and collect co-payments and deductibles.

·Medical Billing: Process insurance claims, appeals, and denials.

·Medical Coding: Assign and enter appropriate procedure and diagnostic codes.

·Accuracy: Ensure correct and thorough demographic information for medical records database.

High Academic Honors Recognition / Dean’s List

Microsoft Office Applications: MS Excel MS Word MS PowerPoint MS Outlook MS Teams

Computer Softwares: Google Docs Google Meet Zoom MedX Typing Speed: 38 WPM

KEY QUALIFICATIONS

Medical Practice Management Systems Medical Terminology Medical Records HIPAA Compliance

Insurance Verification Insurance Claim Processing Reimbursement Processing Revenue Cycle Management

Medicare / Medicaid Government Payers Third Party Payers CPT & ICD-10 Coding

Medical Billing Medical Office Medical Administrative Patient Registration Data Entry

EDUCATION

Ultimate Medical Academy Diploma – Medical Office and Billing Specialist, 2022

Ultimate Medical Academy HIPAA Essentials for Healthcare Professionals Certificate

Ashville-Buncombe Technical Community College Certificate of Completion – Nursing Assistant, 2006

RELEVANT PROFESSIONAL EXPERIENCE

Concentrix/AETNA – Fremont, CA 10/2022 – Present

Customer Service Advisor – WFH Agent

·Handled inbound and outbound telephone calls

·Adhere to HIPAA law and AETNA procedures and policies

·Provide excellent customer service to Medicare Members (Part C) Medical Providers, and Internal/External Customers

·Salesforce EMR Software: verify patients demographics, healthcare plan, and medical provider data

·EOB (Explanation of Benefits): review the premiums, deductible, out of pocket expenses, and co-payments

·MHK (MarketProminence) Software: manage of the Medicare Health plans, from enrollment/premiums/payments

·Inquiries regarding Medicare Part D are submitted to the assign Pharmacist to further review

·Review CPT Codes/ICD-10 to ensure proper processing and review the billing status of the claim

·Insurance verification: review and confirm the patient’s coverage and eligibility of the healthcare plan

·Medical Data Entry: review and update documentation, medical provider information and incoming data

·Star Central System: review the patients healthcare benefits to validate that status and EOB

·ECHS Software: review prior authorizations and pull referrals

·PNC Systems: review, and process payments from members. Accept credit/debit cards, and check

·HRP (HealthRules/Payor) Software: view medical claims to ensure the data is accurate

Private Duty Care – Old Fort, NC 09/2019 – 03/2020

Caregiver

·Prepared and served meals and assisted with activities of daily living.

·Communicated with medical staff and ran errands.

·Took vital signs and acted with discretion when handling confidential information.

Brightstar Care – Asheville, NC 01/2019 – 08/2019

Certified Nursing Assistant

·Maintained patient safety and provided for the delivery of basic patient care.

·Completed documentation of patient related tasks, assisted with activities of daily living, and took vital signs.

·Ensured the comfort, privacy, and dignity of patients by completing duties in a manner that displayed warmth and promoted a caring environment.

·Met the needs of all assigned patients.

Autumn Care – Marion, NC 06/2018 – 01/2019

Mountain Ridge Health and Rehab – Black Mountain, NC 10/2017 – 05/2018

Certified Nursing Assistant

·Attended to the individual needs of patients including assistance with grooming, oral hygiene, feeding, incontinent care, colostomy care, prosthetic appliances, transferring, ambulation, and range of motion.

·Checked vital signs, applied creams and ointments, collected specimens, and documented services provided.

·Made outbound phone calls, helped with ambulation and transferring, and trained new hires.

·Monitored intake and output and performed all responsibilities in accordance with prescribed safety procedures.

Black Mountain Neuro Treatment Center – Black Mountain, NC 03/2013 – 01/2017

Certified Nursing Assistant

·Handled inbound and outbound phone calls, trained new hires, and documented services provided.

·Helped with activities of daily living, applied creams and ointments, and collected specimens.

·Communicated and interacted effectively and tactfully with patients, visitors, families, peers, and supervisory staff.

·Maintained the comfort, privacy, and dignity of patients by completing duties in a manner that displayed warmth and promoted a caring environment.

All Kids Pediatrics – Asheville, NC 01/2010 – 01/2012

Medical Administrative Assistant

·Interfaced with patients via inbound and outbound phone calls.

·Administered vaccines, took vital signs, checked patients in, and collected copayments.

·Verified insurance coverage, trained new hires, called in prescription refills, and reviewed insurance claims prior to submitting.

Westwood Assisted Living – Asheville, NC 04/2006 – 11/2009

Medical Office Assistant

·Completed med tech training in order to distribute medications.

·Scheduled appointments, handled inbound and outbound phone calls, and documented services provided.

·Trained new hires, conducted interviews, hired candidates, maintained office files, and ordered supplies.

Additional experience includes 1+ year as a Stay-at-Home Parent in Asheville, NC

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