Customer Service Sales
Resume:
Torsha Barbee-Carter
Memphis, Tennessee 38109
Cell: 901-***-****
Objective
Seeking a challenging and responsible management position offering opportunity for growth and advancement.
Summary
Ability to take initiative and successfully follow through on a project from conception to completion. Always conscientious,
energetic, with excellent customer service skills Detail oriented. Reimbursement experience with in-patient hospital
l admissions, outpatient setting, durable medical equipment and physician office.
Experience
Memphis Health Center October 2010-February 2011
Manager Patient Access Services
• Managed registration, scheduling appointments, insurance verification, prior authorization and cashiering
• Created and implemented standard operating procedures
• Centralized patient access services, including managing inbound and outbound calls to the Call Center.
• Responsible for off-site locations
• Weekly reporting on encounters and cash collections to Chief Financial Officer.
• Worked with billing manager to resolve any billing issues.
• Foster a positive work environment, high standards of customer service , innovation and teamwork.
• Ensure compliance with standards , laws and regulations by regulatory and accrediting organizations such as
OSHA, JCAHO , State and Federal Governments etc.
Smith & Nephew Orthopaedic Corporation January 2007-March 2010
Reimbursement Supartz Biologics Division
• Manage Supartz Reimbursement hotline team.
.Deliver presentations for in-house training to sales representatives on reimbursement and services Supartz reimbursement area offers to assist in generating revenue.
• Main point of contact for denials and appeals
• Developed and implemented processes to improve efficiency.
• Schedule and monitors vacation time to ensure adequate staffing.
• Coordinate workflow of reimbursement specialists.
• Knowledge of CMS regulations and pricing.
• Strong knowledge of Medicare guidelines.
• Generated weekly and monthly reports on Excel spreadsheet on benefit verifications received daily.
• Verify coverage for Supartz Joint Fluid Therapy with carriers such as Medicare, Commercial, PPO, Auto claims and Workers’ Compensation.
• Identify specialty pharmacies contracted with individual insurance plan.
• Educate sales force and billing manager on billing and reimbursement for Supartz.
• Partner with Sales and Marketing on reimbursement strategies to expand business and generate revenue.
• Answer all reimbursement questions including ICD-9 coding and HCPC coding.
• Resolve billing denials and insurance appeals.
• Offer excellent customer service and reimbursement expertise.
• Work directly with the sales team, director’s of sales, reimbursement managers, and marketing managers.
• Assist in the acquisition of new accounts for Supartz.
• Expert of HIPPA and Privacy Laws.
Smith & Nephew Orthopaedic Corporation December 2000-December 2006
Exogen Reimbursement Specialist, Exogen Fracture Healing Device
• Partnered directly with sales representatives as liaison between patients and insurance companies
• Obtained authorization on Durable Medical Equipment for the Exogen 2000+ Unit.
• Expert in individual plan policies and requirements for multiple states.
• Verified insurance for auto claims, worker’s compensation, PPO, HMO, Commercial, Medicaid, and Medicare .
• Acted as liaison between insurance companies, sales reps, physician offices, and attorneys.
• Ensured information entered in system is complete and accurate to bill insurance carriers.
• Interacted with immediate supervisor and manager of reimbursements to resolve difficult insurance issues.
• Negotiated special rates with worker’s compensation and auto claims adjusters, including self-pay patients.
• Negotiated rates with non-contracted providers.
• Assisted Reimbursement Managers in acquiring contracts with non-participating providers.
• Expert knowledge of HIPPA guidelines and privacy laws.
Methodist Healthcare Central April 2000-August 2000
Patient Access Services Supervisor
• Supervised 12-14 employees.
• Worked bed control in Admission/ER Registration areas.
• Verified commercial insurances, Medicare, Medicaid and TennCare benefits.
• Prepared medical record charts from ER Registration discharges for the Medical Records Department.
Methodist Alliance Home Medical Equipment May 1997-April 2000
Sr. Customer Service Representative
• Processed orders and referrals for equipment and medical supplies for patients, physician offices and other institutions and companies.
• Verified insurance eligibility for Medicare, TennCare Mississippi and Arkansas Medicaid and commercial for individual patients.
• Processed orders for patients on a monthly basis.
• Handled multi-line phones.
• Acted as liaison between customer and insurance company.
• Reviewed medical records for insurance verification for equipment orders.
• Trained other customer service representatives.
Lebonheur Children’s Medical Center August 1990-May 1997
Registration Supervisor, Admissions
• Evening and night shift supervisor
• Maintained personnel files, attendance records, and work schedules.
• Managed staffing as needed.
• Assisted with special projects including benchmarking process.
• Supervised 14 employees
• Prepared medical record charts for ER and Urgent Care patients including outpatient services.
• SAP Time verification
Skills
• Windows 2000
• SAP
• Excel
• Microsoft Outlook
• MicroSoft PowerPoint
• Lotus 1-2-3
• Dbase III
• Word Perfect and 10 Key
• Medifax System Typing
• Fax Machine
EDUCATION
Bachelor of Business Administration, Belhaven University GPA 3.34 To Graduate April 26, 2012
Business & Human Resource Management, Southwest College 1998-2001
Contact this candidate