Customer Service Representative - Medical Billing

YASH KHEMANI

Customer Service Representative Medical Billing Specialist

Remote-Ready

************@*****.*** 890-***-****

PROFESSIONAL SUMMARY

Compassionate, customer-obsessed healthcare service professional with over 3 years of professional experience, including over 18 months in dedicated customer service resolving claims, benefits, and billing inquiries for U.S. health plan members, employers, and providers, including direct experience supporting Aetna, BCBS and Priority Health accounts. Skilled at active listening, empathetic communication, and first-call resolution in fast-paced, 24/7 contact-center environments handling calls, chats, and email correspondence. Proven ability to educate members and providers on benefits, claims, and available resources; research and resolve issues; document outcomes accurately in EPIC software and collaborate across teams to improve satisfaction and inspire trust. Adaptable, respectful, and kind in every interaction, with strong problem-solving and decision-making skills and the ability to manage multiple resources in a fast-paced environment. Comfortable working independently in a remote, telework setting with reliable high-speed internet and flexible schedule adherence.

WORK EXPERIENCE

Customer Service Representative at AGS Health Dec 2024 - June 2026 Revenue Cycle Management US Healthcare Corewell Health [Michigan, USA]

● Handled 40-50 inbound/outbound calls daily with 95% accuracy while maintaining quality and compliance standards across a high-volume constraints environment.

● Actively listened to and advocated for patients, employers, and providers, resolving claims, billing, and benefits inquiries via inbound/outbound calls in a 24/7 rotating-shift contact center.

● Managed correspondence with major U.S. healthcare payers including BCBS, Aetna, and Priority Health, researching claim status, denials, and billing discrepancies to drive first-call resolution.

● Educated members and providers on benefit plans, claims processes, and available resources, guiding them through their options and ensuring clarity with kind, respectful interactions.

● Anticipated member and provider needs, proactively flagging likely follow-up issues and offering solutions before they escalated, improving overall satisfaction.

● Documented all customer correspondence and maintained confidential records of patient information accurately in EPIC software supporting compliance and audit-readiness.

● Followed payer policies, procedures, and compliance/code-of-conduct standards on every account, ensuring quality and accuracy across all interactions.

● Collaborated with cross-functional teams and other departments to resolve escalated billing and claims issues and improve overall service outcomes.

● Consistently met adherence to assigned schedules and performance metrics across a 24/7 rotating-shift structure, supporting reliable, round-the-clock coverage.

● Supported outreach and upselling of supplemental benefit add-ons (dental, vision, supplemental benefits) via various social channels, strengthening member engagement and retention.

● Handled a high volume of varied inquiries daily with adaptability and empathy, maintaining quality and accuracy while managing multiple cases in a fast-paced environment.

Freelance Web Developer May 2023 - Nov 2024

Self-Employed Remote

● Designed and built websites and web applications for small U.S.-based businesses, managing client requirements end-to-end from planning through deployment.

● Communicated directly with clients to gather requirements, provide updates, and ensure final deliverables matched business needs and branding.

KEY SKILLS & COMPETENCIES

Customer Service

● Claims resolution and billing discrepancy management

● Benefits education and member/provider advocacy

● First-call resolution

● Empathetic, kind, and respectful communication

● Complaint and escalation handling

● Healthcare correspondence (calls, chats, email)

● Inbound and outbound call handling

● Hospital account / provider-side claims support

Technical Tools

● EPIC

● GoHighLevel

● Microsoft Office (Word, Excel, Outlook)

● CRM documentation and case notes

● Contact-center / dialer systems

● High-speed remote/telework setup

Soft Skills

● Active listening

● Empathy and patience

● Adaptability across accounts and processes

● Problem-solving and decision-making

● Multitasking in fast-paced environments

● Cross-team collaboration

● Schedule adherence and reliability

● Proactive, solutions-first mindset

CORE STRENGTHS

Putting People First

Consistently prioritized patient and provider well-being over transaction speed, taking time to fully understand each concern before resolving it.

Joining Forces

Worked closely with billing, claims, and provider-relations teams to resolve multi-step issues that required more than one department to close out.

Inspiring Trust

Built member and provider confidence through consistent follow-through, transparent communication, and accurate documentation of every interaction.

AVAILABILITY & WORK SETUP

● Immediately available for remote employment

● Willing and able to work flexible or rotating shifts, including U.S. business hours

● Reliable high-speed internet and a dedicated home workspace already in place

● Experienced with adherence to assigned schedules in a 24/7 contact-center model EDUCATION

Bachelor of Commerce — Rajasthan University (2020-2023) High School — Jaipuria Vidyalaya (2018-2020)

LANGUAGES

English (Fluent) Hindi (Native)

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