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Description
- Position Type:
- Full-time
- Desired Experience:
- 7 - 10
- Salary Range:
- 15 - 0 Hourly
Denise V Duncan 8830 Roaring Pt Drive Houston , Tx 77088 Cell: (832) 215-3180 (281) 901-3791 denisedncn@yahoo.com Summary: Over 6 years in the Medicaid eligibility field, complemented by an extensive background in network/ payer relations and contract administrations. Able to work under minimal supervision, able to learn new tasks quickly, great customer service skills, appreciated by management for ability to take charge of special projects and functions. Desires employment with an established company in a professional environment, which offers both job stability, and career oriented advancement opportunities. Work History:Associate Service Operations Specialist, Coventry Health Care, Houston,TxJune 2007 to PresentResponsible for one aspect of service including, but not limited to, processing claims adjustments, enrollment and eligibility records, and Medicare Set Aside (MSA) referrals, reviewing, acknowledging and reporting receipt of client files, responding to customer inquiries, and resolving customer concerns within a team environment to meet or exceed customer service requirements. Patient Support Representative, Resource Corp of America, Smyrna, Ga Nov 2005 to April 2007Screen self-pay patients @ bedside for eligibility to receive SSI-Medicaid benefits or state Medicaid assistance. Determine whether they meet the medical and income requirements for assistance. Complete applications and gather necessary forms and documents. Develop and submit case files to appropriate agency. Negotiate and follow-up with related agency, as patients representative, in order to secure maximum benefits. Ambulatory Care Representative/ PRN, Emory-Adventist Hospital, Smyrna, Ga 08/06-12/06Greet patients as they come into the Emergency Department for treatment. Interview and collect demographic information for the registration process. Obtain proof of identification and all insurance information and input it into the hospitals system. Verify all information before registration process is complete for accuracy before submitting to ER nurse. Maintain and follow policies and procedures to ensure patient confidentiality. Administrative Cash Office Clerk, Lowe’s Home Center, Atlanta, Ga2004-2005Accurate balancing of transactions and receipts. Ensure proper security over all operational funds. Process and file daily business transaction reports. Prepare cashier tiles for next business day. Greet all customers in a friendly, professional manner and provide quick responsive customer service. Public Benefits Advocate, The MASH Program, Houston, TX2003-2004Screen self-pay patients @ bedside or via phone for possible assistance with their hospital bill. Determine whether they meet the medical and income requirements to apply for SSI-Medicaid through SSA or state Medicaid assistance through DHS. Gather necessary forms and documents and submit them to the appropriate agency on behalf of patient. Follow up closely with agencies, as patients representative, in order to secure maximum benefits. Account Representative/ Team Leader, Cardon Healthcare, The Woodlands, Tx2000-2003Contact patients via phone or mail regarding their unpaid hospital bill. Train account representatives on specific policies and procedures as they relate to the SSA and state regulated programs. Schedule secondary screening interviews with the patients and the Social Security Admin when needed. Monitor account status with the appropriate agency in order to secure payment. Education: Opelousas Senior High, Opelousas , La Durham Tech Community College , Durham , NC Skills: Microsoft Word, TexMedNet, Microsoft Outlook, Internet, Word Perfect, Transaction Entry, Customer Service, Authorizations and Precertifications, GHPGAPortal, AS400 Achievements/Memberships:Provided successful HIPPA and FDCPA training to coworkers Volunteer Experience:YMCA
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