Customer Service Medical
Resume:
Karin Downer
*** ***** **** ********* #**, Brooklyn, NY 11226
***********@*****.***
OBJECTIVE: College graduate with an Associate Degree seeking a position in a health care facility where I can utilize my education, training, and skills.
SKILLS & QUALIFICATIONS:
• Medical Office Administration, Law, and Ethics
• Clinical Office Procedures
• Phlebotomy, EKG, Urinalysis, & Vital Signs
• Excellent Time Management and Organizational Skills
• Excellent Communication, Interpersonal, and Customer Service Skills
• MS Office for Windows 2007
• Extensive Data Entry
• Medical Billing and Medical Records
EDUCATION:
2009 - 2010 ASA Institute - The College for Excellence, Brooklyn, NY
Associates Degree in Occupational Studies (Major in Medical Assisting)
EXPERIENCE:
2011-2011 Americare Inc., Brooklyn, NY
Field Staffing Assistant
• Staff all new case’s (SOC) start of cares daily.
• Assign case managers to all initial cases per census and team.
• Fax all new cases and coverage’s to appropriate community health nurses.
• Inputs all primary nurses and case managers into McKesson daily.
• Ensure all cases entered in McKesson have a primary nurse and case managers associated.
• Schedule initial visits in interactive scheduler.
• Daily Monitoring of staffing log.
• Assign new primary nurse for all coverage’s requested (request for coverage)
• Cover cases for community health nurses (vacation, sick, etc.)
• Submit coverage’s requests to the scheduling dept. daily for schedule update.
• Communicate all primary nurse changes to scheduling dept. to ensure accurate schedules.
• File coverage, and keep binders for all request
• Make sure all community health nurses meet weekly productivity
• Make sure all patients with Americare have a nurse assigned for home visit to administer care.
• Administer proper customer service
• Assist in the training of new staff.
2005- 2011 Rite Care Medical, Brooklyn, NY
Medical Billing / Medical Records Analyst / Medical Records Supervisor
• Verify and bill 150 + patients insurance eligibility per day. Verify accuracy of billing data and revise any errors.
• Identify mistakes in reports, and obtain the correct information.
• Check medical charts for accuracy and completion.
• Perform extensive data entry and process no-fault and workers’ comp claims.
• Set up patient accounts for billing in a variety of proprietary application software.
• Analyze and resolve claim issues from denial and collection reports.
• Fill out order forms, determines charges, and coverage for service requested.
• Handle high volume multi phone lines and logged all calls route messages to the appropriate party.
• Call physician to obtain correct information and answer physician’s questions about patients.
• Review and collect insurance information and calculate charges and collect co-payments.
• Verify patients insurance and obtain authorizations.
• Organize and update patient’s medical records as needed.
• Follow up and send correspondence letters to patients and doctors.
• Organize and updated physicians information in the patient charts.
• Solicits sales of new or additional services.
• Assist insurance companies with selections of the correct billing codes, and the equipment, and the service selection.
• Enter data, such as demographic characteristics, history and extent of disease, diagnostic procedures and treatment into a billing system.
• Speak with customers that are dissatisfied, coordinate corrections of the complaints, ensure service recovery, and recommend corrective services to adjust complaints.
• Maintain professional communication between patients, medical staff, and department heads, and physicians.
• Assign appropriate CPT-4 procedure code(s) to accurately report the physician service.
• Assign appropriate ICD-9 diagnosis code(s) to accurately support each physician service.
• Transmit correspondence and medical records by mail, e-mail, or fax.
• Protect the security of medical records to ensure that confidentiality is maintained.
• Retrieve patient medical records for physicians, technicians, or other medical personnel.
• Release information to persons and agencies according to regulations.
• Plan, develop, maintain and operated a variety of health record indexes and storage and retrieval systems to collected, classified, stored and analyzed information.
• Compile and maintain patients' medical records to document condition and treatment and to provide data for research or cost control and care improvement efforts.
• Process patient admission and discharge documents.
• Transport medical records to various departments and maintain inventory of discontinued medical records.
• Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.
2000-2000 Long Island College Hospital, Brooklyn, NY
Medical Receptionist
• Performed administrative duties answering phones, scheduling, rescheduling, filing, copying, faxing, and entering extensive data entry on a daily basis.
• Filed, faxed and mailed correspondence to outside business.
• Prepared billing statements for the billing department.
• Handled incoming and outgoing mail. Organized and maintained files.
• Scheduled patient’s appointments for MRI, CAT Scans, X-rays.
Reference available upon request
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