Insurance Verification Administrative Support
Resume:
La’Fiera M. Burr
Waco, Tx **706
****.**.******@*****.***
Summary
● Highly organized and efficient in fast - paced multitasking environments; able to prioritize effectively with creativity, enthusiasm and humor.
Education
LaVega High School Waco, Tx 76705
Experience
Baylor Scott and White(pss)
4/24/2023-present
The Patient Services Specialist 1, with direct oversight, provides administrative support in a physician office, clinic or other operational area that assists patients, to ensure high quality, patient-centered care. Duties include patient relations, check-in and check-out, scheduling, insurance verification and answering phones.
Assists with patient duties to include patient relations, check-in or check-out, scheduling, insurance verification, and answering phones. Arranges follow-up visits and referral appointments.
Assists with patient registration duties by collecting and verifying insurance information. Verifies patient demographics and enters changes into computer system. Directs patient to appropriate waiting areas.
Accepts payments for physician/clinic services according to established guidelines. Posts payments and enters charges into computer utilizing appropriate codes. Generates daily payment reports and verifies cash drawer against report. Provides accurate patient, medical, financial or procedural information to patients or approved outside entities. May be required to discuss financial arrangements with patients.
Receives and directs phone calls. Assists patients and other visitors. Responds to routine inquiries concerning practice services, hours of operation, etc. Ensures any patient complaints are handled appropriately.
Assists with medical records duties as requested.
Submitting referrals on behalf of the doctors
operating a phone tree, routing calls, fielding inquiries through chat and phone) required.
Department of veterans affairs
07/17/2022-4/21/2023 (call center,Help Desk)crm Experience
• Receives inbound telephone calls, emails, or VA IRIS (Inquiry Routing and Information System) inquiries from Veterans, caregivers, VA staff and other users related to the My HealtheVet website, eBenefits website, Web and Mobile Solutions
• Assist in the triaging and resolution of trouble issues reported such as, but not limited to, password resets, website and mobile application usability; navigation; and troubleshooting of features and functionality
• Receive inbound telephone calls from Veterans, Veterans family members and/or legal representatives, the public, and VA employees regarding VA and related non-VA benefits available to Veterans, dependents of Veterans, and beneficiaries.
• Provides timely feedback to customers on service request status, resolution actions, and preventive measures for the requests.
• Provides efficient instruction or training to customers about use of website. Explain the process of filling out a claim for benefits, eligibility requirements, forms and other relevant information.
Blue cross and blue shield
02/26/2022-07/07/2022 (customer service)
Helping providers and members with pre-Authorizations. Submitting them and checking status.
And also checking on referrals
Checking to make sure providers is in network with members plan
Waco Family medicine
11/21/2021- 2/26/2022(Front Desk Clerk)
enter patient’s service charges in computer system, collect current and overdue service charges, adjusting patient’s account and printing receipt, secure a daily cash box, reconcile daily charges and receipts. Answer phones, taking and forwarding messages and scheduling appointment
Baylor Scott and white
Oct,26,20- 11/19/21(customer Advocate, provider)
Under general supervision, communicates to Members and Providers policies, procedures and services of the Plan to ensure complete knowledge of the Plan. Assists Members with access to the Plan system, and helps members pick an appropriate physician, and assist with appointments.
Must adhere to call handling goals of 80% of calls answered within 30 seconds. Helps and adheres to call abandonment rate of less than five percent (5%) with average hold time not to exceed 2 minutes based on regulatory requirements. Within 60 days of employment on the floor, must meet monthly quality goal of ninety-two percent (92%) or greater based on two percent (2%) of calls monitored. Helps and meets schedule adherence goals based on department policy successful completion of proficiency testing following initial Advocate training.
Serves as a primary contact for benefits, claims status and simple drug inquires for Personal Plans with working knowledge of other products, based on first contact resolution guidelines. Verifies demographic information on all inquiries and updates the Plan system.
Assists Members with concerns and effectively works toward a resolution before the concern escalates to a complaint.
Accesses appropriate sources to obtain benefit information requested by Member and Providers.
Acts as liaison between Members, Providers and billing offices, with follow through to resolve issues.
Accurately documents phone log records for each inquiry with appropriate messaging based on department standards.
Verifying Members insurance for providers
Crm Experience
operating a phone tree, routing calls, fielding inquiries through chat and phone) required.
November 2017 - March 2020
American Income Life, Waco, Tx - Customer service rep
● Answer an average of [63] calls per day by addressing customer inquiries, solving problems and providing new product information
● Investigate and resolve customer appeals and complaints in a timely and empathetic manner
● Recipient of multiple positive reviews acknowledging dedication to excellent customer service
● Direct calls to appropriate individuals and departments.
● Implement improvements in manual and electronic billing procedures
● Make changes and adjustments to customer’s account
Also taking payments and submitting claims for death and other claims
Letting customer know what type of policy they have and who is all on the policy
General Dynamics
Waco, TX
09/09/2013- 05/31/2017
• Responsible for supervising customer service agents and other staff.-Trains, coaches, and mentors employees on how to deliver the best customer service possible.
• Investigate customer's problems and find solutions.
• Communicate with customers via phone, email, or letter.
• Hire, train, and terminate customer service agents.
• Provide scripts to read from during phone calls.
• Handle major incidents that cannot be resolved by agents.
• Resolve complaints and order issues.
• Ask customers to provide feedback on agents and customer service experience.
Isolate and identify areas of improvement.
• Train agents on how to adequately address problem over the phone or how to write correspondence.
• Work with management on customer service. Qualified to be a supervisor as well
Contact this candidate