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Resume for Medical Customer Service Agent

Houston, Texas - US

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  • Job Target: Medical Customer Service Agent
  • Employment Status: Employed - Actively Looking
  • Experience Level: Mid Level
  • Seeking: Not Specified
  • Industry: Managed Care Resumes
  • Salary: 27,000
  • Degree: Bachelor's Degree (BA/BS)
  • Security Clearance: None
  • Travel: Heavy
  • Relocate:: Yes

Resume Tags Resume for Medical Customer Service Agent all tags

Objective

Seeking a position as a Medical Customer Service Agent where I can utilize my experience, skills and knowledge in the best possible way.

Job Target

Medical Customer Service Agent

Professional Experience

2010 – present Intracare Hospital
Case Manager
Houston TX

•Developing and implementing the treatment plan, psychosocial evaluation and discharge planning on children ages 4 to 12, who have experienced physical, sexual, and emotional abuse and also behavioral problems that interfere with daily life, family.
•Implemented psychosocial evaluation discharge planning on adolescents and adults who have psychiatric and substance abuse problems.
•Work in connection with Texas Department of Family and Protective Services in order to help children find placement in foster care, and residential treatment centers.

2008 – 2010 United HealthCare
Intake Coordinator
Houston TX

•Provided administrative support and performs other duties as assigned.
•Answered telephone inquiries according to established grade of service standards.
•Collected and verified information concerning eligibility, provider status, benefit coverage, and coordination of benefits on the telephone from members.
•Complied with organizational policies and procedures, regulatory requirements and other established criteria and guidelines.
•Assisted in preparing and submitting reports or assignments as needed to meet organizational initiatives and/or objectives.
•Maintained confidentiality of company and protected health information.
•Provided behavioral health customer service functions and coordinates member needs with appropriate level of care on the telephone.
• Referred members to network behavioral health providers for outpatient evaluation and treatment.
• Performed data entry of authorizations and customer contacts for mental health facilities.
•Basic research and resolution of claims issues

Education

2008 University of Houston Downtown
Psychology – Bachelor's Degree (BA/BS)
Houston TX

Skills

  • Experience with hospital and physician billing experience
  • Experience with Self Pay Accounts, HMO, and PPO accounts.
  • Knowledgeable of EOBs, CPT & ICD-9 Codes, HCFAs, UB92s, HCPCS, DRGs and authorizations/referrals
  • Experience with Dialer, and IDX

Relocation Preferences

No preference

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Last updated on: 2011-01-18.