Customer Service Specialist
Resume:
Olguine Billy
*******@*******.***
Objective: 27 years of diverse customer service specialist and collection specialist. Implement policies and procedure for the ancillary department. Experience in billing and coding. posting charges for three offices. Analyze and edit patient bills, generated by providers through the electronic medical record. Collection specialist to contact clients and collect outstanding payments, truck a balance between maintaining relationships and timely payments.
Work Related Experience:
Kaiser Permanente
Customer Service Representative II Oct 2023- Present
Update member demographic, modify existing information, answer, and document incoming calls.
Responds professionally to inquiries from internal and external customer. Promotes, ensures, and provides customer service to internal and external customers by demonstrating skills which are consistent with the organization’s philosophy of providing extraordinary customer relations and quality service. Initiates contract with the appropriate health plan medical group for information’s.
Documented any information or conversations with member according to procedure.
Assist with eligibility and benefit inquiries. Understand and apply relevant policies processes and customer information. Address escalation to Tier 3 for KPC Billing, 1095 Tax Form. And SLP.
Responsible for billing inquiries, payment processing, Eft inquiries, reinstatement requests, and service reviews. Follow established procedures to meet customer, member needs.
Responsible investigate and issues written reports on customer complains. Resolve customer complaints. Listening with empathy and using a creative approach to problem solving.
Evaluate data and determine appropriate course of action for complain resolution and service recovery. Handing difficult client issues related to health plan service, policies, and procedures.
Follows established procedures to meet customer and member needs.
Responsible for health plan by answering question and documenting all incoming contracts to determine their nature. Maintains the privacy and confidentiality of information to protect the assets of the organization.
Respond to complex calls related to specialized product line or queues.
Northside Hospital
Patient Access Representative Mar 2017 - Present
Implement policies and procedure for the Ancillary Departments
Responsible for greeting and checking in patient in friendly manner.
Obtain and enter demographic, clinical.
Understand the importance of dealing with confidential information.
Carry out insurance verification, consent, and notification.
Explain and obtain signatures on admission, clinical and financial forms.
Determine expected cost for service being rendered.
Identify all insurance payer sources verify insurance eligibility and obtain insurance's notification.
Assisted patients with all aspects of insurance billing resolution or payment and documented any information or conversations in the computer regarding the patient's accounts.
Handle the tasks of collecting co-payments and verifying insurance coverage and handle the tasks of collecting and posting payments as well as record receipt balance nightly deposits.
Responsible collecting past due balance. Experience in a patient accounting, financial counseling.
Met with patients to explain the cost treatment insurance coverage and patient responsibility.
Thoroughly investigated past due invoices and minimized number unpaid accounts. Completes medical financial assistance survey EFORM based on analysis of patient financial information.
Explain a variety admission forma and policies and discussions financial responsibility and obtain payment. Check-in patients by verifying and updating demographic.
Research past due patient accounts and medical billing setting.
Interview patients to accurately obtain all opening information require for admission and discharge records and forward them proper departments.
Healthcare Specialty: Solving, strong analytical, trouble shooting skills.
Responsible to training new employee for all department.
Responsible answer questions regarding insurance and patient accounts and providing good customer service. Extensive 10 key, typing skills and basic mathematical calculations.
Experience of HMO, PPO, Managed Care, and Indemnity plans. Experience of current ICD codes and CPT codes.
WELLSTAR HEALTHCARE SYSTEMS, Atlanta, GA
Medical Imaging Scheduler Jul 2014 –Jan 2017
Responsible for scheduling patients for various radiology exams throughout the organization
Answering a multi-line phone system to ensure we schedule each patient in a timely manner.
Facilitates the scheduling, canceling, and rescheduling of patient appointments.
Communicate changes to staff as needed.
Providing preparations and coordinating with the physician's offices to schedule the patients correctly.
Update patient demographic, modify existing information, verifying ICD-10 diagnosis codes, procedure, and insurance information.
Inbox ‘s new orders from outside physicians and adding orders in the Healthconnect
Responsible for performing a wide variety of clerical duties that require independent decision making.
Responsible to scheduling diagnostic procedures enters data in scheduling system, provide customer with appointment instructions.
Responsible inbound and outbound calling to patients.
ANCHOR HEALTH CENTERS, Naples, FL
Team Leader Mar 2007 - Sep 2012
Maintain QA statistics (including patient wait times, etc.) and report results to Supervisor.
Register all patient types.
Maintains effectiveness of patient flow.
Release lab order to the tech.
Assume on-call responsibilities to ensure adequate staffing and problem-solving Oversee the daily activities of the registration area to ensure department standards are met.
Assists Supervisor in educating registration staff of any changes pertinent to their roles.
Collect/request deposits and copays.
Posting Charges, conditions of service, consent financial.
Cash control policies and procedures.
Scan protected health information.
Creating and file patient information packet, folders for upcoming
Verifies insurance, benefits, coverage, and eligibility, completes assigned registration financial clearance work lists activities.
Provided excellent customer services.
Interviewed and trained new employees.
Resolve patient account disputes and balance due through the establishment of payment agreement, assists in resolving patient concerns.
Demonstrates knowledge and understanding of organizational policies, procedures and systems, daily closing.
Home Depo, Atlanta GA
Customer Service June 2006-Jan 2014
Answer and direct calls to the correct department. Compose various correspondence letters and process.
them accordingly. Provide excellent customer service by knowing information about products.
Training new employees and process returns. Inputting data in the system accurately within the time allocation. Take payment with credit card, cash payment, Check payment and cash posting.
Making new orders for customer and updating information in the system. Addressing customer concerns and immediately resolve customers’ issues by providing best possible solution.
Lely Elementary school, Naples, FL
ESE Secretary Aug 2005-Mar 2007
Monitor various reports, tracks students for placement purposes. Answering multi-line phone and take messages.
Process inventory and order supplies, maintain ESE audit files. Assist in processing transfer student information. Perform other duties as assigned.
I operate microcomputer and other office machines to include word processing and reproduction service. Prepares various ESE forms and maintains ESE files.
Contacts appropriate individual for ESE staffs and conferences. Sets up meetings Maintain ESE records and charts. Accessed, input and retrieves information and data from computers.
Internship
Kim I. McHale & Associates, New York
Office Administrator Oct 2002-2004
Typed various correspondences and processed them accordingly. Input data on the system accurately with the time allocation.
Responsible to following up with the client and provide clients with status for the case.
Sorted and annotated all incoming mails.
Update client’s information on the system. Create files on the new clients on the system. Make Doctors’ appointments for clients and advice the clients involve accordingly.
Responsible for translation of English to Creole. Prepares forms and composes. Set up and maintain files.
Bed Bath and Beyond NY, NY
Cashier Nov 2002-May 2004
Customer Service: Cashiers are the main point of contract for customers, they greet customers, answer questions, and resolve complaints. Check-out: cashiers ring up sales, bag items, and collect payment. They also honor coupons and give change. Return and exchanges; Cashiers handle return and exchanges efficiently.
Responsible to training new hires.
Payless Shoel NY, NY
Key Hold Mach 200- SEP 2002
Effectively managed the key holder responsibility by ensuring that store keys and access codes are properly safeguarded. Led and supervised the daily operation of staff and maintained a safe working environment for customers and employees.
Responsible for opening and closing the store, monitoring daily sale, and ensuring that the store is properly secured
each day.
Senses Perfume Homestead, FL
Cashier Jully 1998- Feb 2000
Assisted customer with processed over 5,000 transactions to date with 100% accuracy, handling cash, credit card, and electronic payments. Maintain a friendly and welcoming attitude, providing excellent customer service. Resolve customer complaints with a 97% Satisfaction rate. Trained and mentored 9 incoming cashiers, improving their efficiently accuracy by 25%
Software: HP Chat, Foundation, Financial Estimation tool, Eligibility Inquiry, Benefit Inquiry, Premium Billing, Services Billing, Claims, Coverage Changes, MRN Service, Demographics/profile preferences, ACI V4, SLP- Production, Tempus Payment Portal, Microsoft Word, Word Perfect, Microsoft Excel, Power Point, EPIC,, Med- Metrix Analytx Portal, Microsoft Outlook and Microsoft Access.
Katharine Gibbs College
New York
08/02-03/04
Associate Degree for Legal Administration
References
Will be provided upon request
Contact this candidate