Customer Service Accounts Receivable
Resume:
Ruth Williams
Nashville, TN ***** • 615-***-**** • *********@*****.***
Skills
SAP, SalesForce, DEFOA
SharePoint, Learning Management System (LMS), TEDS, Philips University
The ability to interact professionally, work independently and as a part of a team
Customer Service, Communication and Interpersonal Skills
Working Knowledge of Insurance Claims and Billing
Microsoft Office Suite (Excel, PowerPoint, Word, Outlook, Internet Explorer)
Training and Negotiation Skills
Rx Home Software (Prescription Account Management System)
Reimbursement/Billing Software (National Council for Prescription Drug Programs software, Claims Engine 2000)
Problem-Solving and Decision-Making skills
Work Experience
Philips Healthcare, Nashville, Tennessee
Service and Delivery – Dispute Resolution 07/2022 - Present
Obtain agreement to pay from customers upon resolution of disputes.
Process, generate, and send out customer invoices via email on daily basis; work closely with the logistics team to obtain proof of deliveries
Research, analyze, and dispute customer deductions and credits within a consumer product industry
Coordinate and collaborate with accounts receivable (AR), customer service, order management, and sales support personnel to resolve disputes and to substantiate claims and deductions with proper documentation
Issue credits and/or working with order processing to complete necessary transactions.
Researching and resolving customer issues and discrepancies relating to payments and/or invoices.
Assist with month-end closing surrounding invoices, credit memos, adjustment issues, and reconciliations
Participate in ongoing performance improvement initiatives (first time right invoicing activities)
Conduct AR credit/debit offsets
Work closely with the collections team to ensure credits issued are applied to the appropriate invoice and to ensure that disputes are resolved so that collector can obtain payment.
Philips Healthcare, Nashville, Tennessee
Contract Operations – Credit Contract Adjustment Specialist 01/2021 – 07/2022
Processing service contract adjustments and credits per existing policies and procedures, ensuring that all terms and conditions are satisfied
Researching and resolving customer-initiated billing disputes, clearing a path to cash and communicating resolution actions directly to the customer
Partnering with Accounts Receivable to resolve payment application discrepancies, ensuring offsets and adjustments are applied correctly
Utilize critical thinking to analyze complex contract requirements, special provisions, pricing, internal approvals, and terms and conditions to ensure compliance with appropriate laws, regulations and corporate policies
Proven ability to work with business partners; streamlining processes and creating cross-functional partnerships
Display role model behavior; train and coach others as opportunities arise
Seek out opportunities to challenge yourself and others; finding new ways to positively affect the team, the customer, and the business
Assist with fiscal close procedures
Escalate items as needed to management, partnering to drive solutions
Philips Global Business Services, Nashville, TN
Medical Registration and Authorization Specialist 11/2019 – 12/2020
Obtain Medicaid Authorizations for treatment, follow up on authorization request, identify expiring authorizations
Accurately maintaining patient files and current authorization information
Review claims for the accuracy of procedures, diagnoses, demographic and insurance information
Obtain and enter referrals, payer changes, equipment upgrades, information updates, etc.
Reviewing and correcting all claims/charge denials and edits that are communicated via Explanation of Benefits (EOB)
Philips Global Business Services, Nashville, TN
Service Parts Order Desk Specialist 10/2018 –11/2019
Place orders for parts per customer request
Follow procedures and guidelines set forth by the company to ensure that all customer orders meet regulatory requirements
Perform Quality Monitoring
Meet metrics/standards set forth by the company
Understand the needs of each customer and ensure each need is met
Handle high volume customer calls while providing excellent customer service
Resolve disputes and handles customer complaints
Accredo Health Group, Nashville, TN
Senior Prior Authorization Representative 11/2013—10/2018
Facilitates cross-functional resolution of drug coverage issues & proactively address, researches & resolves issues impacting revenue optimization.
Performs medical /pharmacy benefit verification requiring complex decision skills based on payer and process knowledge resulting in on boarding or no starting a specialty patients.
Contacts benefit providers to gather policy benefits/limitations. Coordinating and ensuring services provided will be reimbursable (e.g., deductible amounts, co-payments, effective date, levels of care, authorization, etc.).
Directly interfaces with external clients.
Performs medical /pharmacy benefit verification requiring complex decision skills based on payer and process knowledge resulting in on boarding or no starting a specialty patients.
Provide expert assistance to clients on patient status.
Liaison for company providing referral status reporting.
May negotiate pricing for non-contracted payers and authorize patient services and ensure proper pricing is indicated in RxHome.
Handle Escalations.
Use discretion & independent judgement in handling pt or more complex client complaints, escalating as appropriate.
Completes other projects and additional duties as assigned
Aerotek Temp Services / Accredo Health Group, Nashville, TN
Patient Access Representative 05/2013--11/ 2013
Facilitates cross-functional resolution of drug coverage issues & proactively address, researches & resolves issues impacting revenue optimization.
Performs medical /pharmacy benefit verification requiring complex decision skills based on payer and process knowledge resulting in on boarding or no starting a specialty patients.
Contacts benefit providers to gather policy benefits/limitations. Coordinating and ensuring services provided will be reimbursable (e.g., deductible amounts, co-payments, effective date, levels of care, authorization, etc.).
Directly interfaces with external clients.
Performs medical /pharmacy benefit verification requiring complex decision skills based on payer and process knowledge resulting in on boarding or no starting a specialty patients.
Provide expert assistance to clients on patient status.
Liaison for company providing referral status reporting.
May negotiate pricing for non-contracted payers and authorize patient services and ensure proper pricing is indicated in RxHome.
Handle Escalations.
Use discretion & independent judgement in handling pt or more complex client complaints, escalating as appropriate.
Franklin Eye Center, Franklin, TN
Medical Receptionist 09/2012—05/2013
Greets patients and visitors, responds to questions/concerns and directs them to appropriate location. Provides on-going communication with clinical staff regarding patient status.
Collects and enters all necessary demographic, clinical, billing and insurance information from patients or responsible parties.
Explains processes and forms to patients prior to securing signatures and ensures that all documents are properly signed and witnessed as required.
Determines and accepts required payments, including co-pays and deductibles.
Produces admission paperwork on each patient and distributes in a timely manner to appropriate departments/staff.
Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
St Thomas Heart, Nashville, Tn
Front desk registrar 04/2010—05/2011
Gathers necessary demographic, insurance and clinical information from patient and enters into appropriate database. Seeks appropriate resources to resolve issues about the type, date or location of prescribed procedures.
Schedules patient procedures in a manner that most efficiently utilizes the patient's time and clinical resources. Coordinates and communicates schedules.
Assists with coordination of activities related to insurance pre-certification/authorization.
Provides counseling to patient, participant or their representative regarding pre-service requirements and instructions
Education
Whites Creek Comprehensive High School
Nursing Assistant Training Specialists
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