Customer Service Medical Office

Regina Williams

**** ********* ****, *******, **. *************@*****.*** 321-***-****

Education

Aug 2016-present Columbia College Orlando, FL

Bachelors of Arts in Human Services Anticipated graduation date June 2019

Oct 2012 – June 2014 City College Altamonte Springs, FL

Associate of Science degree in Allied Health – Medical Office Management

Billing and coding GPA 3.66

Objective: Seeking a position to obtain employment within the travel industry while utilizing relevant educational training, and several years of outstanding customer service. While exerting great attention to details, where my customer service, excellent oral communication, critical thinking and computer skills would be utilized its fullest degree. Possessing organizational skills, time management, detail oriented, hardworking determination, dependability, and a strong desire to learn, advance and succeed.

Skills

Excellent customer service skills

Adaptability and ability to work under pressure

Team player with the ability to work communicate with all levels of management

Shows independence and initiative in identifying problems and solving them

Efficiently manages time and priorities

Proficient with Microsoft Word, Excel, and PowerPoint

Basic comprehension of Creole

Oct 2021-Present Sedgwick Orlando, FL

Bill review processor

Responsible for approving or denying medical billing claims, by checking for errors in medical coding or inconsistencies in a patient’s diagnosis.

Responsible for being able to process and review bills in timely manner while maneuvering through different systems.

Keys pre-coded billing data into the system.

Identifies and forwards complex bills to claims examiners.

Codes provider bills in accordance with claims management system notes and state guidelines.

Follows workers compensation/auto guidelines to evaluate the services.

Compares qualifications of service provider with service provided.

Involved in system maintenance/file maintenance and interface with IT department.

Assists in account batching and distribution of incoming and outgoing mail.

Answers customer service calls from providers, clients and claims examiners.

Jul 2019- Oct 2021 Sedgwick Orlando, FL

Service Center Representative

Responsible for handling all accounts for the intake of claims, as well as providing customer service to all clients on their claims. To provide excellent service to callers regarding claims for multiple lines of business; to expedite the claims application process and provide detailed claim notes on all calls; to resolve issues with one call/one person response; and to direct calls to appropriate escalation path as needed.

Extensive experience in working in the claim I can read claim notes, payment history, clear understanding of diaries, and SIR etc.

I am currently a new hire mentor helping the new hires to be able to navigate in the system live on the floor fresh out of training.

Jul 2016-Jul 2019 OptumRX Orlando. FL

Customer Service Advocate

Working on a strategic team of high touch clients. Answering of all inbound calls from all members, refill all prescription orders, running trial claims to determine co-pay structure and drug coverage

Oct 2014-Jul 2016 American Nurses Orlando, FL

Biller/Collections Manager

Responsible for billing of all patient charts in a timely manner using all insurance portals, checking patients’ eligibility at the beginning of every month. Processing weekly payroll for all vendors and perform weekly collections on all outstanding accounts and posting of all payments.

Sep 2013-Oct 2014 Comfort Suites Hotel Orlando, FL

Customer Service

Daily check in and out of all hotel guest while booking reservation into the hotel data base, generate all reports, answering of multi-line switch board handling of a bank of 350.00.

Aug 2012 – Sep 2013 Amscot Orlando, FL

Financial Services Associate

Sold financial services and assisted customers with cashing checks, cash advances, and money orders

Aug 2010 – Jul 2012 Best Western Lake Buena Vista, FL

Guest Services Representative

Checked guests in and out of the hotel, answered calls, made reservations for guests, and provided customer service to guests during their stay

Jul 2005 – Jul 2010 Days Inn Hotel Tallahassee, FL

Assistant General Manager

Maintained all posting of payments on accounts, made collection calls on accounts with balances, posted credit card payments, reviewed daily audit reports for accuracy, processed end of the month reports, conducted new hire orientation, and hired and scheduled front desk personnel

Jan 2003 – Jun 2005 Amerisuites Hotel Richmond, VA

Sales Assistant

Sold and booked meeting facilities, and processed new group contracts and function agreements

Certification: National Certified Insurance & Coding Specialist –ID Number 876386 CPR-AED Certified 06/2016

Awards

Train the Trainer, Guest Services Award, and President’s List – fall 2012, summer 2013, winter 2013, and spring 2014.

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