Medicare Customer Service Specialist Resume Title

Lisa S. Nevel

*** **** ******, ********, ** *****

* - *** - *** - ****

****.*******@*****.***

Experienced healthcare billing and insurance professional of 20+ years looking to bring strong communication, medicare knowledge, and problem-solving skills to a Medicare Customer Service Rep role. Dedicated to giving providers clear, accurate answers and helping them navigate claims and coverage with confidence. Education

Evansville High (1980 - 1984) Evansville, WI

Blackhawk Technical College (1986 - 1988) Janesville, WI

- Vocational training and certification as a health unit clerk

- Learned proficiency in the principles of healthcare administration, medical terminology, accounting, and medical billing

Employments

EPIC Life Insurance (now WPS), (1990 - 1999) Madison, WI Subrogation Specialist and Enrollment Specialist

- Resolved complex medical and accident claim issues through clear communication with attorneys, insurers, and providers

- Analyzed claims and documentation to determine subrogation potential and ensure compliance

- Prepared accurate case files and correspondence to support timely, fair resolutions

- Maintained monthly billing for group premiums

SSM Health (formally Dean Medical Group), (1999 - 2025) Madison, WI Insurance Follow-up Representative I (1999 - 2001)

- Contacted insurance companies for reimbursement and posted charge tickets Patient Financial Services, Lead (2004 - 2022)

- Resolved escalated patient and provider billing issues using clear, professional communication

- Audited accounts for accuracy and compliance, including responses to Better Business Bureau

- Collaborated with leadership to improve workflowers, customer service processes, and team efficiency

- Provided CPT codes, fee estimates, and written correspondence to support accurate, informed inquiries

- Managed patient inquiry email, providing written and verbal correspondence Insurance Follow-Up Representative II (2022 - 2025)

- Contacted various insurance companies for claim status

- Provided necessary documentation to the payer to assist in assuring reimbursement

(ie. medical records, prior authorizations and contacting coding staff when errors are made)

- Balanced 100% remote position under changing leadership and workflow Noteworthy Skills

- Medicare and payer policy knowledge (Part A/Part B basics, coverage rules)

- Strong customer service and provider support skills

- Multi-system navigation and data retrieval

- Clear written and verbal communication

- Claims research and issue resolution

- High accuracy and attention to detail

- Ability to learn and apply CMS guidelines

- Remote work readiness and time management

- Documentation and case note accuracy

- Problem-solving in fast-paced environments

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