SUMMARY:

• Professional with 4  year's customer service/call center experience in various industries
• Worked with collection system to provide daily communication with delinquent debtors
• Strong negotiations skills
• Multiple administrative duties including but not limited to collecting and processed payments, insurance verifications, and worked aging reports and researched discrepancies
• Created appeals, followed up with insurance providers, and resubmitted invoices
• Time management skills
• Exceptional communication skills both verbal and written
• Proficient with MS Word, Excel, PowerPoint, Outlook, Patient scheduling, Claims processing, Bookkeeping concepts/Financial, Administration and Health Insurance Processing, CMS

PROFESSIONAL EXPERIENCE:

Confidential

Outreach/ Member services Representative

• Perform verbal and written outreach to members who are identified as requiring targeted vision care services.
• Provides telephone follow - up calls to ensure members have completed their preventive care services as indicated by the health management program in which they participate.
• Serve as the initial point of contact for member complaints/grievances
• Responsible for accurately tracking daily outreach activities
• Reach performance and productivity goals as established
• Maintain confidentiality and security of information
• Document and direct complex member issues to the appropriate management level

Confidential

Customer Service Representative/Legal Assistant

• Maintained case organization by establishing and organizing files; monitoring calendars; meeting deadlines; documenting actions; inputting information into file database and case management software; confirming case status with attorney.
• Helps develop cases by maintaining contact with people involved in the case; scheduling depositions; preparing and forwarding summonses and subpoenas; drafting complaints; preparing and filing discovery requests; preparing responses to opposing counsel; generating status reports.
• Maintained communication with clients by maintaining contact; communicating case progress.
• Maintains case costs by verifying outstanding balances with attorney, clients, and providers.
• Supported case preparation by preparing case summaries and materials for mediation conferences; preparing pleadings; monitoring and obtaining discovery responses; organizing materials for team case review.
• Enhances trial proceedings by organizing evidence; preparing exhibits; scheduling witnesses; ensuring that witnesses are ready when needed; taking courtroom notes.
• Updates job knowledge by participating in educational opportunities; reading professional publications.

Confidential

Collections Specialist 

• The duties of a Collections Specialist include collection calls and/or correspondence in a fast paced goal oriented collections department.
• Providing customer service regarding collection issues, process customer refunds, process and review account adjustments, resolve client discrepancies and short payments. Responsible for monitoring and maintaining assigned accounts- Customer calls, account adjustments, small balance write off, customer reconciliations and processing credit memos.
• Accountable for reducing delinquency for assigned accounts.

Confidential 

Collections Specialist  

• Handled 100  inbound/outbound calls on average in a call center environment
• Followed up on delinquent accounts
• Finalized communication with delinquent debtors when accounts are past due and charge off
• Negotiated and set up payment plans and arrangements
• Collected and processed payments

Confidential 

Medical Billing / Collector/ Claims

• Review patient bills for accuracy and completeness and obtain any missing information
• Knowledge of insurance guidelines especially Medicare and state Medicaid
• Follow up on unpaid claims within standard billing cycle timeframe
• Check each insurance payment is for accuracy and compliance with contract discount
• Call insurance companies regarding any discrepancy in payments if necessary
• Identify and bill secondary or tertiary insurances
• All accounts are to be reviewed for insurance or patient follow-up
• Answer all patient or insurance telephone inquiries pertaining to assigned accounts

Confidential

Collections Specialist

• Contacted customers to collect outstanding payments
• Handled incoming calls and assisted customers with inquiries about payments
• Informed customers of active foreclosure process and passed on to a processor
• Loan modification explanation 
• Handled 50-100 inbound/outbound calls daily
• Negotiated and set up payment plans and arrangements
• Collected and processed payments

Confidential  

Pharmacy Technician/ Call Center Representive

• Provided excellent customer service while multi- tasking in a high volume call center environment to answer physician, pharmacy and client queries
• Checked and verified prescription authorizations and overrides using an internal database
• Handled or redirected client complaints and concerns as needed
• Followed CMS guidelines and regulations closely
• Client follow-up in a timely manner
• Assisted management with additional task as needed
• Maintained a high rate of client retention through quality service

Confidential                      

Pharmacy Tech

• Followed HIPPA privacy standards
• Verified patient demographic against prescription to ensure correct patient receives medication
• Assisted with the pulling, labeling and filling of prescriptions provide quality, empathic customer service throughout the entire drop off/ pick up process