Customer Service Supervisor/Manager

STAR ROBINSON

***** ***** ****

Gaithersburg, MD 20878

301-***-**** Home

240-***-**** Cell

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

PROFILE SUMMARY

Sixteen years of experience in Medical Billing Office Management and Customer Service. Excellent interpersonal skills with a personality to work harmoniously with a wide variety of customers and staff. Familiar with all aspects of daily business operations including Personnel, Human Resource issues, HIPPA, OSHA compliance, contract negotiations, payroll and other numerous administrative functions.

QUALIFYING SKILLS

* Medics Premier Software, ADS, HAS, ENS, Microsoft Word, Excel, PC ACE, Medicare Florida Shared System Async Passport, Atlapoint, APEX electronic billing, and other various software

* Time Management, organizational, and bookkeeping skills

* Account Management – Accounts Receivable/Accounts Payable

* Customer Service

ACCOMPLISHMENTS

* Expedited company debt to profit by analyzing and implementing effective strategies to ensure faster payment with minimal denial errors.

* Strong knowledge of medical billing to analyze reimbursement trends, responsibilities include reviewing Explanation of Benefits for accuracy, generating appeals, reporting on status and process, reviewing denial reports, identify payer trends, researching claims histories and all areas of billing operations, in addition to other customer service functions

WORK EXPERIENCE

Corporate Health Resources, Rockville, MD 04/09-Present

Network Specialist

* Network examiner that provides occupational health exam, assist management/safety staff in identifying and implementing necessary employee occupational health programs

* Prepare shipping of forms, medical records, and lab supplies. Provide data collection, medical forms, medical records, and vendor information with instructions.

* Track employees who need follow up and or referrals for future evaluations

* Employee applicant scheduling, instructions, and follow up on all exams

* Timely turn around of medical qualification notification to clients

* Assist with scheduling of tests and exams for current and long term testing

* Examination results/ work restrictions and exposure history

Capital Home Healthcare, Leesburg, VA 03/07 – 9/08

Medical Billing Manger

* Manage over 400 commercial accounts

* Improved denial errors by investigating all top payers and rectified all situations by correcting software issues

* 80% success rate retrieving claims within 30 days

* Researched causes of denials

* Solve all electronic billing errors by 95%

* Participate with multidisciplinary therapies

* Responsible for negotiations, completing and submission of all contracts with insurance companies.

* Post all charges and payments for insurance companies including transmission of all electronic claims and clearing house

Imagimed, Rockville, MD 06/05 – 3/07

Medical Billing Specialist

* Responsible for all EDI applications with all major insurance carriers in the State of Maryland, New York and Pennsylvania (Trailblazer Medicare, Highmark Medicare, Empire Medicare, Upstate Medicare, BCBS, Medicaid, and Commercial carriers)

* Assessed EDI applications for credentialing purposes to ensure individual and group provider numbers were linked to the organizations Submitter ID numbers for electronic submissions

* Analyzed and eliminated system errors to expedite faster payment

Montgomery Therapy, Rockville,MD 12/01 –04/05

Medical Office Manager

* Managed business from start up development of over 2000 accounts

* Strengthened repeated business referrals, increasing business by %75 within 5 years, marketing

* Oversaw daily medical office operation, managing 5 employees, 10 therapist (non clinical)

* Responsibilities included administration, billing, personnel issues, Human Resource policies and procedures, oversee inventory and purchase of medical supplies

* Hired and trained staff

MAMSI Health Plans, Frederick,MD 01/95 – 08/00

Supervisor

* Collaborated with up to 150-175 Federal Government Employees daily and handled all government regulations.

* Selected to train and service Federal guidelines, policies and procedures

* Supervised and trained 20-40 Federal Government Member Representatives.

* Served on a five-person team to analyze and develop a training system for new hires and train them for all insurance products (HMO, POS, PPO, Indemnity)

* Maintained compliance with areas such as OSAH, HIPPA, coding issues, and updating policies and procedures

* Researched and resolved escalated issues

* Served as a liaison to our Marketing Department

EDUCATION

Montgomery College

Rockville, MD 1993 - 1994

Major – Criminal Justice

Austin Community College

Austin, TX 1991 – 1993

Major –Criminal Justice

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