AART Certified/BMO
Demostrates the ability to achieve results.
Authorized to work in the US for any employer
Work Experience
Provider Service Representative
CarePlus Health Plans - Tampa, FL
November 2012 to Present
Addressing provider questions regarding claims, and benefits for members enrolled in the medicare advantage HMO health plan with careplus health plans. Claims are verified for payment status, or denial and reason. Benefits are confirmed for providers at the provider service level, which included member financial responsibilities, coverage limitations, and perscription coverage. This position heightings my knowledge of CMS guidelines, Hippa laws, and steps to claims processing.
Medical Assistant
Pulmonary Associates of Brandon - Brandon, FL
September 2011 to October 2011
Responsibilities
Providing patients with care pertaining to pulmonary assistance. Duties did include retrieving vital signs, performing injections, and all other tasks requested by the physician.
Provider Service/Claims Rep
Coventry Healthcare - Tampa, FL
November 2010 to August 2011
Knowledge Worker's Compensation Insurance claims processing methods.
Daily task would involve payment status for claims, denial reasons, worker's compensation coverage details for members in all 50 states.
Follow-up on issues not immediately resolved.
Process claims and verifies authorizations and referrals.
Greet customers in a courteous, friendly, and professional manner.
Prepare complete and accurate work and update customer file.
Effectively transfer misdirected customer requests to the appropriate party.
Contribute ideas on ways to resolve problems to better serve the customer and/or improve productivity.
Participate in activities designed to improve customer satisfaction and business performance.
Offer solutions to basic customer issues.
Customer Service
Citrus Healthcare - Tampa, FL
March 2008 to October 2010
Responsible for establishing contact with both internal and external customers.
Interfaced with customers via approximately 50 inbound call per day for the purpose of resolving routine problems with products or services.
Verify health insurance benefits for providers and members.
Knowledge of Medicare, Medicaid, and individual health insurance plans.
Follow-up on issues not immediately resolved.
Process claims and verifies authorizations and referrals.
Greet customers in a courteous, friendly, and professional manner.
Prepare complete and accurate work and update customer file.
Effectively transfer misdirected customer requests to the appropriate party.
Contribute ideas on ways to resolve problems to better serve the customer and/or improve productivity.
Participate in activities designed to improve customer satisfaction and business performance.
Offer solutions to basic customer issues.
X ray tech/medical assistant
Pulmonary Associates of Tampa - Tampa, FL
March 2010 to April 2010
Responsibilities
Responsibilities: assisted Dr. with positioning patients for upright, and recumbent x ray examinations of the chest. Responsibilities also would include taking, and, recording vitals, administering injections(b12), and also helping to maintain a clean working environment.
Accomplishments
While with Pulmonary associates of Tampa I was able impact the office with my efficient, and effective work ethic. I was continuously praised helping the office run the operation...
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