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Clinician Support Agent
Demonstrated experience with Customer Service Representative.
Demonstrated experience with Medical Billing & Claims Processing.
Demonstrated experience with CPT, HCPCS, ICD-10 Coding.
Demonstrated experience with Medicare, Medicaid, Private Insurance.
Demonstrated experience with Patient Scheduling & Coordination.
Clinician Support Agent open to new opportunities
Assisted patients with EKG notifications related to medical devices.. Sent faxes and emails to cardiologists regarding device alerts.. Educated patients on how the medical device provides timely notifications.. Handled inbound/outbound calls for patient and provider follow-ups and closed tickets using Salesforce.
Responded to patient, physician, and insurer inquiries via phone, email, and voicemail.. Ensured accurate patient demographic entry and conducted mental health benefit verifications.. Generated, audited, and processed outpatient claims; handled rejections and followed up on unpaid claims.. Obtained authorizations for services and investigated potential insurance fraud.. Applied HCPCS, CPT, and ICD-10 codes accurately in claims processing.. Maintained HIPAA compliance and cross-trained staff in billing procedures.. Participated in meetings and took on new assignments to support departmental improvements.
Scheduled patient appointments for medical check-ups and managed pharmacy refill requests.. Created patient cases and ensured timely follow-ups on healthcare needs.. Provided answering services for U.S. healthcare facilities and completed physician order entries.. Relayed lab results and other critical patient information to ensure continuity of care.
Maintained and documented Medicare claims decisions.. Coordinated with customers and attorneys regarding claims.. Completed reserve changes and processed Medicare contractor payments exceeding $10,000.. Handled Medicare D pharmacy, Advantage plans, and group health claims.
Supported members with medical and pharmacy claims and benefit inquiries.. Managed durable medical equipment return and exchange processes.. Provided benefit information to UnitedHealthcare members.
Handled billing, order status, and follow-ups for Sprint mobile customers.
Assisted Virgin Mobile customers with billing, number porting, and basic troubleshooting.
Provided billing, subscription support, and technical help for SiriusXM Radio activations.
Assisted Capital One customers with billing, balance transfers, and credit card activation.