Medical Customer Service Representative Resume Samples

As a Medical Customer Service Representative, the person will be responsible for managing large amounts of inbound and outbound calls. The other associated duties are listed on the Medical Customer Service Representative Resume as follows – handling all scripts and documents, acting as a liaison between the company and the customers; taking responsibility for evaluating all documents; obtaining correct information for billing purposes; entering patient information into the system database; ensuring customer satisfaction and assisting them with issues and concerns; handling patient referral sources and communicating with insurance companies and prior authorization requests.

Those seeking to work in this line should depict in the resume such skills as – superior customer service skills, knowledge of customer needs and trends, telephone speaking skills, knowledge of insurance coverage policies and procedures, and multitasking skills. While formal education requirement includes only a high school diploma or GED, possessing a relevant certification or work experience will be useful.

 

Medical Customer Service Representative Resume example

Medical Customer Service Representative Resume

Summary : Medical office, claims, scheduling, benefits verifications. Over 20 years of great customer sevice skills in the medical and tele communication , accounts receivable field.

Skills : Communications, Great Computer, Customer Service, Sales.

Description :

    1. Promptly answers, screens, and processes medical service requests and telephone inquiries with strict adherence to confidentiality agreements and policies and procedures.
    2. Provides information on programs, policies, and procedures.
    3. Collects and enters patient intake information into the appropriate medical service software system to initiate the transaction.
    4. Documents are to be concise, thorough, and accurate.
    5. Reviews all patient information and submit payment request.
    6. Meets Service standards in all categories on a monthly basis.
    7. Meets the expectations of our internal and external customers in providing excellent service.
Years of Experience
Experience
10+ Years
Experience Level
Level
Senior
Education
Education
Associates


Sr. Medical Customer Service Representative Resume

Summary : Consistent in meeting and exceeding expectations of job requirements and management. Proven to be a leader in and used as a mentor among co-workers. Modifies work activities to eliminate wasted effort and efficient in using work day to be most productive. Disciplined and works without supervision and is able to maintain a high level of work product and has the respect of management and co-workers.

Skills : Customer Service, Management.

Description :

    1. Contacted referrals and patients to schedule equipment deliveries or to obtain needed medical documentation.
    2. Verified various insurance plans and eligibility.
    3. Completed the most successful orders within the Austin branch.
    4. Failed fax reports.
    5. Confirmed orders received from various referrals.
    6. Collected and updated demographics and insurance information
    7. Verified of health plan eligibility
Years of Experience
Experience
10+ Years
Experience Level
Level
Senior
Education
Education
Bachelor's


Jr. Medical Customer Service Representative Resume

Objective : Extensive experience in Healthcare and operations with an emphasis in tele-health care, call center environment and customer service, and a proven leader with the ability to analyze complex situations and develop creative solutions in demanding environment. Received recognition for superior performance in identifying key issues and setting forth interventions.

Skills : Phlebotomy, Patient Registration And Real Estate.

Description :

    1. Effectively instructs and educates families and visitors on logistics of hospital procedures in accordance with policy.
    2. Responds appropriately to notifications from electronic systems, including ORMIS Patient Tracker system, OCIS Information Desk Database, Electronic Bed Board and the Daily Census Report.
    3. Discusses patient information in accordance with the HIPAA policy.
    4. Consistently solicits input and communicates with people from diverse cultures and backgrounds to respond to customer needs.
    5. Responds to 90% of phone calls within one working day or in accordance with office standards.
    6. Exhibits excellent interpersonal, organizational and management skills.
    7. Cross-trains and provides back-up for other customer service representatives when needed.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
Associates

Medical Customer Service Representative I Resume

Objective : To provide the best customer service possible no matter the career. Take pride in work and determined to be the best by standing above the rest.

Skills : Active Listening, Typing.

Description :

    1. Took inbound calls from patients for various reasons, examples being: scheduling appointments, processing payments, verifying insurances, credit checks, signing patients up for our program, as well as answer any questions or handle any concerns they might have.
    2. Sent email reminders, and did follow up phone calls regarding appointments and or conflicts they may have.
    3. Worked very close with management to the point of raises and various special projects.
    4. Helped train new employees when they began working.
    5. Ranked among one of the better CSR'S statistically.
    6. Taken complete and accurate messages.
    7. Scheduled mutually acceptable appointment times utilizing an electronic practice management system.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
Bachelor's

Medical Customer Service Representative II Resume

Headline : To obtain a new challenging position where excellent customer service/management skills and knowledge will be effectively utilized while providing career advancement opportunities.

Skills : MS Office, Management.

Description :

    1. Provided quality Bilingual customer service for inbound calls in a timely manner.
    2. Responsible for answering any questions members may have about plan.
    3. Resolved any member issues with prescriptions, authorizations and etc.in a timely manner.
    4. Responsible for a daily log of phone calls per day and primary care physician changes for members.
    5. Responsible for ordering over the counter medications for members and assisting them with questions in regards to the medications provided.
    6. Provided general information for new members that wanted to join plan and direct them to the correct person for processing.
    7. Assisted providers with any billing or claim questions, or general information about a certain plans.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Bachelor's

Medical Customer Service Representative III Resume

Summary : Motivated individual seeking Medical Customer Service Representative position where to utilize experience with the opportunity for growth.

Skills : MS Office, Management.

Description :

    1. Answered incoming calls within a call center, provided information on behalf of medical worker's compensation clients and providers.
    2. Received requests by mail, telephone regarding claim status.
    3. Identified coding and billing problems from EOBs and worked to correct the errors.
    4. Provided administrative support to the Clinical Review department if needed.
    5. Explained reconsideration procedures.
    6. Mailed or route claim forms and supporting documentation to various units for final processing.
    7. Responded to inquiries grievances, complaints or appeals.
Years of Experience
Experience
7-10 Years
Experience Level
Level
Management
Education
Education
Bachelor's

Asst. Medical Customer Service Representative Resume

Objective : Customer service enjoy working with other and helping others during stressful and or dire needs.

Skills : Microsoft Office, Management.

Description :

    1. Communicated with pharmacies or medical offices through inbound and outbound calls and written communications Responding to customer questions and helping to resolve their problems Using the computer system to track, gather information and/or trouble-shoot issues for customers.
    2. Provided exceptional customer service when interacting with customers, medical professionals and their office staff.
    3. Documented and updated records in the required systems while following company and client requirements.
    4. Remained calm and helpful even when dealing with upset customers.
    5. Escalated customer complaints and/or calls to your manager when necessary.
    6. Provided feedback and recommendations to manager on ways the company can improve.
    7. Performed other duties as assigned by management team.
Years of Experience
Experience
2-5 Years
Experience Level
Level
Junior
Education
Education
Associates

Associate Medical Customer Service Representative Resume

Headline : Ability to direct complex projects from concept to fully operational status. Goal-oriented individual with strong leadership capabilities. Organized, highly motivated, and detail-directed problem solver. Proven ability to work in unison with co-workers, managers, and executives.

Skills : Management, Organizing.

Description :

    1. Performed various duties that required multi-tasking skills in a fast paced environment.
    2. Coordinated with internal departments and external resources (multiple data sites) to address inquiries by members and providers.
    3. Reviewed processed claims to identify payment information, denial reasons, claim errors, etc.
    4. Educated and consulted members and providers about Medicare and Quest medical plan benefits.
    5. Utilized Encoder coding software and CPT, ICD-9-CM, & HCPCS coding manuals to identify coding errors Manage day to day operations by utilizing various computer software applications, MS Word, Excel, Power Point, Outlook, QNXT medical database platform, and Contact Client call management software.
    6. Promptly answered patients' billing and medical questions with strict adherence to confidentiality agreements, HIPAA, and policies and procedures.
    7. Followed work flow processes via the EPIC computer system in order to get a claim processed and paid, resolve customer complaints, and to log billing discrepancies.
    8. Supported the management team in identifying operational opportunities for continuous improvement and initiating changes to center processes as needed through use of company approved procedures.
Years of Experience
Experience
5-7 Years
Experience Level
Level
Executive
Education
Education
Associate's

Lead Medical Customer Service Representative Resume

Summary : Ambitious, detailed oriented, hard worker seeking a position where can utilize the excellent interpersonal skills, phone manners, office etiquette, computer knowledge and exceptional communication skills garnered through previous work experience and college coursework at a growth-oriented firm, which will allow to both further utilize skills and acquire new abilities.

Skills : Customer Focus, Customer Service, Data Entry.

Description :

    1. Reviews internal databases to complete accurate and timely follow-up on pending and inactive claims.
    2. Contacts the insured, insured's representative or provider to follow-up on information needed to process the benefit inquiry.
    3. Keeps clear and concise documentation of all claim activity within the internal databases.
    4. Meets quality and production metrics as established and communicated by the department.
    5. Processes requests from the client or from other departmental areas within LTCG.
    6. Answers calls from policyholders, members, agents, providers, hospitals regarding benefits or other issues.
    7. Answers claim benefit questions from callers on both group and individual products.
    8. Provides solutions to problems, confirm eligibility, and/or plan coverage.
Years of Experience
Experience
10+ Years
Experience Level
Level
Senior
Education
Education
Administration

Medical Customer Service Representative Resume

Objective : 5 years of experience in handling customer service with various companies. Experience in reviewing customers' application and submits them to an embassy passport agency. Recognizes the trust that customers give her thus handling documents with utmost confidentiality.

Skills : Management, Organizing.

Description :

    1. Provided customer service to our members.
    2. Helped customers find the correct plan for their needs.
    3. Solved issues the customer may have had with their billing issues.
    4. Explained their benefits and how they worked.
    5. Found doctors near by for the members.
    6. Assisted in helping members with the health exchange.
    7. Processed 90 patient requests by telephone daily regarding health insurance.
    8. Provided counsel and guidance to clients for benefit plans, adjustments and claim status.
    9. Researched and interpreted policy and provisions.
Years of Experience
Experience
0-2 Years
Experience Level
Level
Entry Level
Education
Education
Bachelor's