A Customer Quality Specialist will be responsible for qualifying orders for patient orders. A well-drafted Customer Quality Specialist Resume indicates the following duties and tasks – identifying the correct insurance and other qualifying clinical information, informing patients and referral of outstanding information to process orders, acquiring the needed information, creating accurate order for patients; verifying insurance eligibility and benefits of patients; processing information received from service personnel; maintaining appropriate documentation received with orders, and resolving patient and customer complaints.
The most sought-after skills for the post include the following – strong communication proficiency, business acumen; basic skills in Access, Excel, PowerPoint and MS Project; and mathematical skills; the nature of the job demands fulfilling the needed physical demands as well. A high school diploma or GED is the needed requirement, relevant prior work experience is also preferred.
Objective : Competent customer quality specialist strives to exceed sales goals and build long-term relationships with customers. Facilitate positive experiences through high-quality customer care and prompt resolution of complaints and issues.
Corrected Insurance inpatient accounts if it has changed between visits.
Obtained social security number, date of birth, the correct ID number for insurance and correct insurance if it was not sent over from referral.
Worked project pushing PIF's from status 1 to status 2, which means putting in the patient's insurance if necessary or correcting it and filling in therapy information from referral information.
Received on the patient which includes items that are being ordered, going through the clinical and obtaining method of feed, a physician that order and their NPI number and diagnosis codes.
Worked project to fill out and file/fax WCOVO's (Written Confirmation of Verbal Order).
Required follow-up of WCOVO to make sure the WCOVO's were corrected if errors made and faxing to Ordering Physician when ready.
Worked overtime and all Mandatory overtime.
Experience
2-5 Years
Level
Junior
Education
Leadership
Sr. Customer Quality Specialist Resume
Summary : To obtain an Customer Quality Specialist position in the Healthcare Field in which can utilize skills, experience and education to be an asset to a professional organization.
Skills : Microsoft Office, Excel, Medent, Nextgen.
Description :
Answered incoming calls for order placement of home medical equipment prescribed by a physician.
Collected patient information for the data entry process.
Worked closely with case managers/nurses to assess diagnosis and obtain necessary documentation/qualifications for billing purposes.
Provided to obtain health benefits and to request and follow up with authorization if required for reimbursement.
Contacted patients to go over any copayment or patient responsibility due according to their health insurance plan, collect co-insurance and schedule for delivery of medical equipment.
Handled both the delivery and revenue confirmation reports for the Tulsa branch.
Consisted kept the report at or less than 0.5% at month-end.
Experience
10+ Years
Level
Senior
Education
Business Administration
Jr. Customer Quality Specialist Resume
Objective : Overall 8 years of experience in Team Handling, Quality check, Customer support and administration. To obtain a part-time or full-time position that will utilize skills and experience.
Skills : Communication, Claims And Processing, Data Entry, Data Analysis.
Description :
Verified insurance eligibility and benefits of patients.
Obtained verbal/written authorization for medical treatment from appropriate sources.
Verified insurance information for accuracy and completeness and resolves discrepancies as needed.
Obtained clinical information needed for order processing or reimbursement.
Advised them of the order placed on their behalf and to confirm all patient demographic information; to communicate any financial responsibilities and/or additional information necessary for processing the order received; to promote other company products and services, as appropriate.
Processed information received from intake/service personnel.
Ensured proper selection of information online to ensure timely delivery and appropriate revenue recognition for the order.
Maintained appropriate documentation received with order and conducts follow-up as applicable.
Demonstrated professional etiquette and courtesy when interfacing with customers.
Experience
2-5 Years
Level
Junior
Education
AS In Health
Customer Quality Specialist III Resume
Summary : Dynamic professional with Customer Quality Specialist experience of more than 1.5 years in Virtual Administrator, Maintenance & Operations, Process Enhancements and Team Management.
Worked with Customer Accounts, and acted as a Liaison, between the Airline Customer and Boeing.
Processed Customer concerns from Spars load through Aircraft Delivery.
Worked with Customers, from around the world, is challenging.
Reviewed for Customer concerns that are addressed as Customer sensitive and SRL, Significant Rework Log.
Weekly status meetings are held and Manufacturing Managers answer Customer concerns.
Worked closely with Boeing Contracts, Program Management Office, Sales, Engineering, Customer Relations, and Manufacturing.
Developed highly empathetic client relationships and earned a reputation for delivering exceptional customer service.
Experience
7-10 Years
Level
Management
Education
Customer Service
Customer Quality Specialist II Resume
Headline : A challenging Customer Quality Specialist
position in the healthcare industry, where there is a need for a variety of management tasks including, computer knowledge, organizational abilities, business intelligence, and personnel management.
Skills : Customer Service, Professional Administrative, Excellence Social Media Proficiency.
Description :
Received new referrals and verified insurance benefits.
Prep required forms for insurance.
Contacted the referral source for needed information.
Corresponded with patient information needed.
Arranged initial deliveries with branches and patients.
Answered queue calls from insurance representatives, patients, caregivers, and referral sources.
Requested authorizations from insurance.
Experience
5-7 Years
Level
Executive
Education
Customer Service
Customer Quality Specialist I Resume
Summary : Dedicated Customer Quality Specialist professional with a goal to obtain a position where knowledge and experience can be utilized in providing patient's assistance in investigating and resolving escalated insurance issues.
Skills : Management, Front & Back Office, Customer Service, Sales, Accounts Payable.
Description :
Provided home respiratory services and medical equipment including oxygen and inhalation therapies increasing patient quality of life.
Verified insurance information for accuracy and completeness and resolves discrepancies as needed.
Obtained clinical information needed for order processing or reimbursement.
Confirmed demographic information, communicate any financial responsibilities and/or additional information necessary for processing, promote other company product and services, as appropriate.
Processed information received from intake/service personnel.
Ensured proper selection of information to ensure timely delivery and appropriate revenue recognition for order.
Maintained appropriate documentation received with order and conducts follow-up as applicable.
Resolved patient/customer complaints by identifying problems and coordinating appropriate corrective action.
Complied with and adheres to all regulatory compliance areas, policies and procedures.
Experience
7-10 Years
Level
Management
Education
Medical Coding
Customer Quality Specialist/Analyst Resume
Objective : Customer Quality Specialist work in a real professional atmosphere that enables to cope up with the emerging as well as the latest technology and which gives the scope of widening the spectrum of knowledge.
Skills : Typing, 10key By Touch, Microsoft XP, Excel, Data Entry.
Description :
Responded to telephone, fax and EDI inquiries and orders from referral sources and homecare patients.
Documented referral requests for coordination of care.
Provided information on equipment supplies and services.
Assisted walk-in patients with the selection of equipment, supplies, and services.
Demonstrated professional etiquette and courtesy when interfacing with customers.
Resolved patient/customer complaints by identifying problems and coordinating appropriate corrective action.
Assessed patient needs and promotes company products and services.
Experience
2-5 Years
Level
Junior
Education
General Diploma
Customer Quality Specialist/Representative Resume
Headline : An astute and competent professional with 12 years of Customer Quality Specialist experience in BPO operations, customer service, operational and systems training, service quality assurance, order to cash, complaint management and customer service delivery.
Verified patient prescription via online or phone contact with hospital or doctor, verified insurance coverage and benefits, coordinated with closing.
Verified insurance information for accuracy and completeness and resolve discrepancies as needed Contacted patients.
Resolved patient/customer complaints by identifying problems and coordinating appropriate corrective action.
Contacted policyholders (e.g. patients) regarding co-insurance payments; Contacted healthcare providers to verify insurance Entered new or recertification information into the system.
Provided customer service for inbound and outbound calls regarding CPAP supplies and shipping those supplies to our patients.
Inputted customer demographics into BPM and ACIS systems.
Updated medical insurance Researched and resolved patient complaints and concerns.
Experience
5-7 Years
Level
Executive
Education
Associate Of Science
Customer Quality Specialist/Executive Resume
Headline : Determined multi- faceted worker with experience rooted in complaint quality systems including the receipt, documentation, processing, investigation, resolution and closure of all product quality complaints in compliance with regulatory requirements.
Skills : Microsoft Office, As400, Medical Billing, Medical Terminology, Customer Service, Typing, Inventory, Quality Control.
Description :
Responsible for receiving complaint products from global sources, reviewing complaint information, and routing products for evaluations within specific departmental and FDA timeframes.
Reviewed complaints about relevant updates for the initiation of Medwatches and subsequent follow-up Medwatches.
Excelled in a leadership role through energetically training departmental coworkers and members of the complaint handling unit alike on daily functions and departmental practices.
Selected for a specialized effort to identify areas of potential procedural pitfalls and affectively championed the implementation of more efficient procedural practices.
Helped bring the completion of complaints under 60-day guidelines.
Activated participants in a select first response group, processing initial complaints emailed to the complaint handling unit and entered those complaints.
Provided excellent customer service to patients ensuring that all orders processed correctly.
Experience
5-7 Years
Level
Executive
Education
Bachelor Of Arts
Customer Quality Specialist Resume
Headline : To advance and excel in personal and professional life, Looking for a long-term career oriented Customer Quality Specialist
position where perform all task to the best of abilities.
Skills : Excellent communication, Computer , Medical terminology, Multi lined phone systems, Customer service.
Description :
Made sure prescriptions and saturation testing is complete and accurate.
Scheduled durable medical equipment for delivery.
Qualified patients for medical equipment with insurance record keeping of productivity.
Greeted and checked patients in for their scheduled appointments and/or pick up of medical equipment and supplies.
Placed orders for medical supplies.
Spoke with patients as well as doctor's offices and insurance companies, to obtain patient records and to retrieve payment if necessary.
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