Front Desk Receptionist & Patient Services

Professional Summary

Offering excellent organizational abilities and readiness to develop in collections field. Brings capacity to quickly grasp financial systems and employs strong data management and customer service skills. Ready to use and develop communication and problem-solving abilities in Collections Developed strong analytical and problem-solving skills in fast-paced environment. Demonstrates ability to manage data, handle sensitive information, and maintain accurate records. Seeking to transition into new field where these skills can drive effective results and contribute to team success.

Skills

HIPAA compliance

Payment Resolution

Organizational skills

Verbal and written communication

Problem Solving Abilities

Attention to detail

Teamwork orientation

Decision Making

Time management

Claims processing

Multi-tasking

Multitasking Abilities

Patient registration

Prior Authorizations

Medicare/Medicaid

Insurance verification

Microsoft systems

Active listening

Medical Billing /Coding

Attention to detail

Medical Terminology

Data entry proficiency

Updating customer accounts

Medical billing

Conflict resolution

Commercial Insurance Claims

Prior Authorizations

ICD-10 Codes

Payment collection

Account Reconciliation

UB-92

Medical Claims Processing

Utilization Review

Pharmacy Claims

Procedure Codes

Prior Authorization

Salesforce

HCFA 1500 Claim forms

Promise Net

EXPERIENCE

PATIENT SERVICE REPRESENTATIVE

Cencora (Amerisource Bergen), February 2020-September 2025

•The Patient Services Specialist is responsible for initiating, researching, completing, submitting, and tracking Patient Services Program applications for assigned facilities.

•The incumbent is responsible for conducting benefit verification and completing necessary third-party prior authorizations, reimbursement activities, patient assistance, and copay program enrollments. Billing Inquiries.

•They may also coordinate refill calls, perform documented adherence activities, and coordinate dispensing for specialty medications, high-cost prescriptions, and/or infusion medications.

•This role requires proactive interaction with facility staff, patients, payers, and patient assistance programs (PAP). Occasional travel may be required.

•Performs patient onboarding, benefit verification, prior authorization, and appeals processes, as needed, on behalf of patients and their physician to facilitate the process between the doctors' office and pharmacy to triage and

streamline prescription fulfillment.

•Provides above services for a health system's ambulatory pharmacy, specialty pharmacy and/or outpatient infusion center environment, as requested.

Customer Service Representative

Adroit Health Group McKinney, TX August 2018-November 2019

Assist patients with Payment issues.

Resolving patients’ issues with their policy.

Reviewing benefits with patients and overviews of policy.

PAYMENT RESOLUTION SPECIALIST/INSURANCE CLAIMS SPECIALIST

Alliance Rx Walgreens + Prime, January 2015-May 2018

•Process orders in Waiting for patients due, researching and releasing orders and assisting patients with billing questions including providing them with Patient Assistance information. Reconciliation of billing issues.

•Process orders in the Waiting for payment queue are over a specified amount by researching payment history, payment options, patient assistance plan membership and outstanding balance order.

•Answers, screens and directs telephone calls on the incoming billing line.

•Provides general information regarding the order and billing related issues in a professional manner documenting all interactions into script med system.

•Responds to incoming correspondence and ensures its proper documentation and attaching them to patient files. Reconciled billing issues and claims processing for medications.

•Verifies patient assistance benefits with vendor and handles internal paperwork to bill appropriate patient assistance plan.

•Coordinates change of benefits when patient has utilized the maximum allowable amount of assistance.

Responsible for verifying pt eligibility, coordinating benefits, running test claims and

•determining patient coverage and responsibility for services.

•Including not limited to primarily major medical insurance benefits verification, complex insurance plan verification and high volume PBM plans.

•Work with diagnosis code, route of administration, place of service, IPA claims, Medicare B & billing Major Medicare, and PBM.

•Verifies patient insurance coverage of medications, administration supplies and related pharmacy services.

•Utilizes all available resources to obtain enter insurance coverage information for ordered services into patient’s file.

•Complete a full medical verification for all medications, administration on supplies.

Phone/ Call Center experience

Web

Provider Portal Electronic

Assisted providers with proper billing codes and modifiers for proper authorization and claims payment.

EDUCATION

General Studies High School

Wilbur D. Mills 1991

University of Arkansas At Little Rock

APPLIED PSYCHOLOGY, Little Rock, AR

Philander Smith College

University of Arkansas At Little Rock

REFERENCES

References available upon request

Contact this candidate