Service Representative Patient
Resume:
Andrea Blue
Patient Service Representative
Sacramento, CA 95823
**************@*****.***
Willing to relocate to: Sacramento County, CA
Authorized to work in the US for any employer
Work Experience
Patient Service Representative
Amerit Consulting Inc.-Sacramento, CA
September 2023 to Present
1. Provide exceptional customer service
2. Follow Federal HIPAA guidelines
3. Provide accurate information regarding claims, prior authorizations and benefit coverage 4. Process Prior authorization requests
5. Claims processing
6. Verify benefit eligibility
Sr Custodian
UC Davis-Sacramento, CA
October 2022 to Present
As part of Environmental Services, I follow hospital standards and assist in patient discharge rooms . Bathroom restocking/ cleaning . 7 steps to cleaning . Utilizing proper PPE precautions . Patient Service Representative
Pyramid Consulting Group-Sacramento, CA
November 2024 to July 2025
Respond to inbound calls, emails, and chat inquiries regarding health insurance plans, benefits, claims, billing, and eligibility.
Provide accurate information and resolve issues with professionalism and empathy. Document all customer interactions in our CRM system. Educate members on plan benefits, provider networks, and processes for claims and appeals. Collaborate with internal teams to resolve escalated issues or complex inquiries. Meet or exceed performance metrics related to quality, productivity, and customer satisfaction. Maintain confidentiality and follow HIPAA guidelines at all times. Stay updated on changes to policies, regulations, and systems. Patient Service Representative III
TriWest Healthcare Alliance-Rancho Cordova, CA
November 2018 to June 2020
Answer calls & determine if Prior authorization is needed for provided HCPC/ CPT codes Provide accurate Eligibility details
Update referral requests for care in the community Assist with processing of Claims
Review claims
Provide accurate and Excellence customer services to Veterans and providers Refer Callers to Local VA Medical Center when no authorization for care is established Medical Records Clerk (Cerner Temp)
Dignity Health-Sacramento, CA
May 2018 to November 2018
Medical Office Representative
Schedule patients
Check-in and checkout patients
Answer calls and rely messages to Drs and Medical Assistance Verify Insurance coverage & Benefits
Load Insurance into Data Base
Follow HIPAA Guidelines
Temporary position to provide assistance while employees under went new system trainings Customer service Rep/ Data Entry
Healthnet Of CA
January 2017 to May 2018
Answer calls & determine if Prior authorization is needed for provided HCPC/ CPT codes Provide Accumulation Details Towards out Of pocket maximums & Deductibles Provide accurate Eligibility details
Update PCP records and PPG assignments for our members Assist with processing of Claims
Review claims & Dofr to determine whom is at risk for the payment of rendered services Provide accurate and Excellence customer services to Healthnet insured members & Healthnet Providers Administrative Assistant/Receptionist
CSM Bakery Solutions-Rancho Cordova, CA
February 2016 to October 2016
Responsibilities
Open/ close office.
Take & Place customer orders and get them ready for delivery Bill and collect payment/Delinquent payments.
Answer multi line phones.
Make Company Deposits
Minimal local order drop off / FedEx pick ups
Copying, filing, scanning
Calculating daily sales per sales representative
Education
Healthcare Office Administration (Certificate)
Carrington College-Sacramento, CA
2009 to 2010
General Studies (High school diploma)
Sacramento county-Sacramento, CA
June 2007 to September 2007
Skills
• Medical Scheduling
• Medical Records
• Microsoft Word
• Cerner
• Medical receptionist
• Microsoft Office
• ICD-10
• EMR systems
• Customer Service
• Fast Food
• Hospital Experience
• ICD-9
• Insurance Verification
• Multi-line Phone Systems
• Medical Office Experience
• Call Center
• CPT coding
• Microsoft Excel
• Data Entry
Certifications and Licenses
CPR & First Aid
Present
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