A Clinical Service Representative takes charge of all tasks relating to patient intake and care. Working mostly in healthcare clinics, and other medical establishments, these professional complete the following tasks as mentioned on the Clinical Service Representative Resume – greeting incoming patients, verifying patient information, updating database, collecting payments, filing paperwork, completing documentation tasks, providing doctors information about patient appointments, scheduling surgery dates, labeling medical documents, helping patients by providing needed information, and handling prescriptions.
Those seeking to work in this capacity should show evidence of the following – knowledge, and experience of healthcare industry operations, medical terminology proficiency, a deep understanding of relevant software, and strong communication skills. Employers pick candidates having experience or training in a medical office.
Objective : To obtain a challenging Clinical Service Representative position within a company that will enable me to effectively utilize my education, office skills, and experience, while allowing me an opportunity for growth and advancement.
Skills : Microsoft Word, Publisher.
Description :
Scheduled therapy for new and existing patients.
Kept tracking of patients that have gone on hold (hospital stays/surgeries) Scheduling ROC evals and Recerts.
Entered therapy orders for all evaluations in the POC (creating the RPOC), and making sure the POC has the correct therapy orders from the MD and the SOC RN.
Verified all evaluations, visits, missed visits and discharges using several reports (especially the Unverified Service Report).
Attached them to the pts charts.
Faxed all evaluations.
Faxed reevaluations, discharges and therapy orders that deviate from the original LOC.
Experience
2-5 Years
Level
Executive
Education
GED
Clinical Service Representative Resume
Summary : Highly qualified Clinical Service Representative with experience in the industry. Enjoy creative problem solving and getting exposure on multiple projects, and I would excel in the collaborative environment on which your company prides itself.
Skills : Healthcare, Customer Service.
Description :
Selected, assigned and audited diagnostic and procedure codes to patient records for a 150-bed, acute-care hospital.
Managed chart completion (ICD-9-CM and CPT coding/abstracting), chart assembly and analysis, patient admission and patient information privacy/security.
Worked collaboratively with patient account department to ensure accurate billing and resolve claim denials and medical-necessity issues.
Reviewed medical documentation and consult with healthcare providers when documentation is inadequate/unclear for coding purposes.
Ordered lab work and x-ray Prioritize patient daily care according to acuity and scheduled patient procedures Assist with patient and family education Utilize PC to enter and retrieve patient data Answer multi-line phone, operate fax and copy machine Helped hospital pass JCAHO inspections by consistently meeting JCAHO requirements.
Evaluated patients Coding/billing Louisiana Extended Care, Lafayette, LA - Unit Secretary Excelled in role requiring the ability to handle a variety of customer service and administrative tasks and resolve customer issues with expediency.
Demonstrated proficiencies in telephone and front-desk reception within a high-volume environment.
Experience
7-10 Years
Level
Management
Education
Medical Assistant Certification
Clinical Service Representative Resume
Summary : A motivated and dynamic professional with over 10 years of providing excellent customer service. I am seeking to utilize my education and customer service skills in a professional setting.
Skills : MS office, Clinical Skills.
Description :
Checked in and out patients, obtaining referrals Verifying insurance I also have experience with obtaining verification with third party payer.
Added assistance to the heavy volume incoming phone lines.
Attended all mandatory in services.
Able to provide patients with accurate and excellent services.
Assisted with the credit card machine malfunction.
Able to utilize the card machine along the with chip reader.
Collected co-pays at the time of patients' visits.
Experience
10+ Years
Level
Senior
Education
MS
Clinical Service Representative Resume
Objective : Responsible for Ensuring Compliance with applicable governmental laws, rules, and regulations, both in the United States and internationally, by completing introductory and annual training and maintaining knowledge of compliance as it applies to your role.
Skills : Clinical Skills, Planning Skills.
Description :
Utilized keyboard, computer, monitor and other types of business communication devices for long periods of time.
Transported wheelchairs, beds and related equipment.
Exposured to communicable diseases, hazardous materials, and pharmacological agents.
Adherenced to unit scheduling requirements, which includes, but is not limited to availability call, on call, weekend, and shift work.
Worked requires lifting 35lbs without assistance, unless special accommodations are in place.
Developed in depth technical knowledge of Imaging, Navigation, Robotics products as well as applicable procedures, anatomy, and implant products.
Provided educational support for new surgeons, OR staff and administrators during INR installs and ongoing customer needs.
Experience
2-5 Years
Level
Executive
Education
Bachelor Of Arts In Psychology
Clinical Service Representative Resume
Objective : A highly motivated professional with extensive background in customer service, behavioral health, education, and medical field. Gained a reputation for accurately completing multiple tasks on time. Known for the ability to work independently and as a team member striving to achieve ultimate customer satisfaction and achieving common goals.
Skills : Microsoft Office Suite, Representative.
Description :
Answered phones on multi-line system.
Scheduled and rescheduled appointments for clinical visit.
Greeted and updated patient demographic and billing information into system.
Made reminder calls to patient for upcoming clinical visit.
Resolved any arising issues or problems.
Collected cash, checks, and credit cards for co-pays.
Responsible for balancing petty cash at end of day.
Experience
2-5 Years
Level
Executive
Education
Bachelor Of Arts In Psychology
Clinical Service Representative Resume
Headline : Responsible for Answering questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors, and also Triaging resulting rework to appropriate staff.
Skills : Typing, Filing, Scanning, And Email Answering Multi-phone Lines, Issuing Receipts, Distributing Mail And Inventory Control.
Description :
Answered telephone, screen and route them to appropriate parties (using telephone paging system if necessary) efficiently.
Taken messages for unit Physicians and Nurses.
Maintained confidentiality of hospital medical records and other patient related information as required by HIPPA.
Reviewed treatment sheets for completeness, ensure nursing signatures are documented, and ensure omitted entries are completed or corrected where appropriate.
Operated tubing system to retrieve and/or deliver information and or materials from one Unit within the Hospital to another.
Typed letters, memos, and other correspondence as required.
Scheduled appointments, consults and other follow up care for patients.
Experience
5-7 Years
Level
Executive
Education
GED
Clinical Service Representative Resume
Objective : Clinical Service Representative with 5+ years of experience in Processing claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system, Educating providers on our self-service options; Assisting providers with credentialing and re-credentialing issues.
Skills : Medical Terminology, Medical Office Procedures, Blood Draws, Vital Signs.
Description :
Processed physician's orders.
Maintained and organized patient records, processed new admit transfers and discharges.
Communicated messages and patient request to nurses, physicians, social workers' and other staff within the hospital.
Responsible for charge stickers on supplies and patient care items from other departments and surgical unit.
Ordered labs, electrocardiogram, and vascular test.
Placed outbound calls to physicians for patient consults.
Contacted the appropriate insurance company to secure and expedite payments through the follow-up and appeals resolution processes, and acting as a functional leader or reference source.
Experience
2-5 Years
Level
Junior
Education
BS In Accounting
Clinical Service Representative Resume
Objective : Clinical Service Representative has a high ability to maintain confidentiality. Has both a strong understanding of HIPAA requirements as well as excellent organizational skills. Great experience as a Medical Records Specialist along with a lot of experience in large counseling practices in a law office.
Skills : Mortgage Loan Officer, Calyx, Microsoft Office, Underwriting.
Description :
Built case management in EMR, and multi-line phone use.
Efficiently provided optimal reception services and translator for the patients and medical staff, using effective communication and organizational abilities thorough knowledge of medicine, pharmacological terminology and medical jargon.
Performed clerical duties such as faxing, copying, emailing, etc.
Interviewed patients, answered calls and queries, register new patients, checking patients in and out, scheduled appointments, confirm appointments mediated with medical staff, assisted patients in completing medical forms and collected co-payments preparing daily cash log receipt and securing cash received as per firm's protocols.
Checked insurance eligibility obtains required Pre-Authorizations and Pre-Determinations when needed and Counsels patients regarding payment options if needed.
Maintained and order front office supplies and record of daily monetary transactions.
Collected and prepared laboratory specimens, sterilize medical instruments, taking medical histories, recording vital signs, prepare for minor surgery, ancillary testing, and preparing patients for examination.
Experience
2-5 Years
Level
Executive
Education
Certified Medical Assistant
Clinical Service Representative Resume
Summary : Determining medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals, Handling incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management and also Performing a review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible.
Skills : Clinical Skills, MS Office.
Description :
Worked with providers and patients in the clinical setting for various Specialists, Allergist, Neurosurgeon & Neurologist, Orthopedic Hand Surgeon and Gastroenterologist.
Functioned as a Clinical Service Representative until changes were made that required a Medical Assistant License for this position.
Transitioned to phones full time for a short time and was then asked to process the Prior Authorization and Referrals for General Internal Medicine 20 hours a week and continue phones 20 hours a week.
Held this position until when the process was streamlined enough to return for processing by the back office.
Demonstrated proficiency in taking patient medical histories and vital signs, as well as in performing various diagnostic procedures and ancillary tests (e.g., EKGs, immunoassays, chemistry analysis, hematology and urinalysis).
Ensured the cleanliness, sanitation and maintenance of all facilities, exam rooms and equipment.
Contributed to the financial viability of the organization by assuring that accounts have been properly billed and collected.
Experience
10+ Years
Level
Senior
Education
MS
Clinical Service Representative Resume
Headline : To obtain a high-level Clinical Service Representative position that will allow me to execute my professional executive support experience and project management capabilities. A team player that has the ability to prioritize multiple tasks simultaneously and work independently or collaboratively in a challenging environment.
Skills : 65 Wpm, Data Entry, 10 Key, Windows, Microsoft, Excel, Eat Trained, Corner, And Epic Trained.
Description :
Expedited check-in/check-out process by reviewing appointment status to view information regarding appointment and insurance information.
Provided customer service for patients accessing multi-disciplinary outpatient clinic serving pediatric and adult patients.
Collected pre-visit payments and communicates with clinical team members regarding factors impacting the patient visit and general clinic-patient flow.
Worked with integrated patient-centered medical home team to provide patient care and perform administrative duties in a friendly and helpful manner.
Inspected insurance cards or authorization notices.
Identified and collected deductibles, co-payments or deposits on services.
Made phone contacts to other departments, physicians, patients and other outside organizations as necessary for the departmental/practice operations.
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