Healthcare Customer Service Resume Samples

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The Guide To Resume Tailoring

Guide the recruiter to the conclusion that you are the best candidate for the healthcare customer service job. It’s actually very simple. Tailor your resume by picking relevant responsibilities from the examples below and then add your accomplishments. This way, you can position yourself in the best way to get hired.

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EC
E Cormier
Ethan
Cormier
99743 Krajcik Trail
San Francisco
CA
+1 (555) 740 5461
99743 Krajcik Trail
San Francisco
CA
Phone
p +1 (555) 740 5461
Experience Experience
12/2014 present
Dallas, TX
Healthcare Customer Service Representative
Dallas, TX
Healthcare Customer Service Representative
12/2014 present
Dallas, TX
Healthcare Customer Service Representative
12/2014 present
  • Make recommendations to implement improved processes
  • Working knowledge of Protected Health Information (PHI), HIPPA
  • During travel, a weekly per-diem is provided but not while on rotations home
  • Self-motivation to work under his/her own initiative
  • Informs management of operational issues impeding performance or customer satisfaction including but not limited to those impacting the customer, client, or the company
  • Maintains exceptional service and integrity with customers and client accounts through accurate, timely, relevant, and quality work efforts of all inventory assigned to the self-pay billing revenue cycle and call center
  • Maintain broad knowledge of products, pricing, promotions, procedures, and other important issues through management communications, meetings, client focus groups, and formal training
04/2008 06/2014
Boston, MA
Healthcare Customer Service Supervisor
Boston, MA
Healthcare Customer Service Supervisor
04/2008 06/2014
Boston, MA
Healthcare Customer Service Supervisor
04/2008 06/2014
  • Manage staffing in accordance with program specific workflow (i.e. down-staffing, up-staffing)
  • Completion of weekly Team Manager Scorecard for review with Operations Manager
  • Manage program specific performance standards (i.e. AHT, Quality Scores, Sales, etc)
  • Manage financial implications of attrition and attendance by maintaining program-specific goals
  • Provides regular supervision and mentorship over subordinate staff
  • Ensure regular and effective communication with subordinate staff on performance, goals, and coaching
  • Facilitates daily agent coaching and development sessions in both written and verbal format
04/2003 12/2007
Los Angeles, CA
Healthcare Customer Service
Los Angeles, CA
Healthcare Customer Service
04/2003 12/2007
Los Angeles, CA
Healthcare Customer Service
04/2003 12/2007
  • Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers
  • Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications
  • Supports payer research, health care policy library, and state management
  • Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly
  • Typically receives little instruction on day-to-day work, general instructions on new assignments
  • Performs related duties as assigned
  • Typically receives general instructions on routine work, detailed instructions on new projects or assignments
Education Education
Associate’s Degree in Independence
Associate’s Degree in Independence
DePaul University
Associate’s Degree in Independence
Skills Skills
  • Strong organizational skills; attention to detail
  • Ability to proficiently use computer and standard office equipment
  • Basic knowledge of FDCPA
  • Basic Knowledge of UB-92 and Explanation of Benefits (EOB) interpretation
  • Ability to proficiently use Microsoft Excel, Outlook and Word
  • Basic knowledge of CPT and ICD-codes
  • Learns to use professional concepts; applies company policies and procedures to resolve routine issues
  • General knowledge of accounting principles, pharmacy operations, and medical claims
  • Strong mathematical skills
  • Ability to resolve associate issues effectively and efficiently
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1

Healthcare Customer Service Resume Examples & Samples

  • We have a variety of work-at-home opportunities, travel assignments and some local positions
  • Our work-at-home assignments require high speed internet services (non-refundable) and we provide a PC or laptop for the duration of your project
  • Our travel assignments are located nationwide and may require 100% travel with rotations home every 6-8wks depending on the client requirement
  • Travel includes your hourly wage, $245/week per diem (paid each Friday ~ no receipts needed, this is yours free and clear), and all travel/hotel/rental car expenses covered in full up front (no out of pocket to you)
  • THIS is a local assignment that would be within 50 miles of your residence
2

Healthcare Customer Service Representative Resume Examples & Samples

  • Maintain a high level of world class customer service/professionalism to a wide range of customers
  • Recommend products that best suit the customer
  • Ability to read and interpret documents. Qualifications
  • Ability to type 30 WPM
  • Must be at least 18 years of age or older Benefits, Benefits and More Benefits!
  • Medical, Dental, Vision, & 401k plans
  • Educational assistance up to $5200 annually
  • Paid Time Off
  • Fun working environment!
  • Company discounts! Local restaurants, gyms, cell phone service discounts, auto, travel, international theme parks and many more!
3

Healthcare Customer Service Resume Examples & Samples

  • Customer call center environment experience
  • HS diploma required, Associates degree preferred
  • Ability to communicate both verbally and in writing, fluently in English
  • Ability to build relationships both in person and over the phone
  • Ability to work proficiently with company software used on the project (i.e. Microsoft Word, Excel, ImageNow, etc.)
  • Ability to navigate various websites
  • Ability to sit and work at a computer for an extended period of time
  • Develops effective working relationships with internal and external clients
  • Meets attendance guidelines
  • Gain general understanding of HMS and office operations
4

Healthcare Customer Service Representative Resume Examples & Samples

  • Receive inbound calls from participants and providers with regards to plan benefits and claim status information
  • Answer participant/provider questions, as well as question callers to obtain full understanding of what assistance is needed
  • Document all calls accurately using call tracking system
  • Monitor call status for responses from other departments, as needed, so call returns are done in a timely fashion
  • Research caller’s issues/problems and find solutions
  • Follow-up with caller within a 24-hour period regarding the initial phone call, even if it is just to touch base and let caller know the inquiry is being researched
5

Healthcare Customer Service Representative Resume Examples & Samples

  • During travel, a weekly per-diem is provided but not while on rotations home
  • Local positions would be considered within 50 miles of where you live
  • As a Dell Associate, you will have access to benefits and retirement plans on the first start day of employment
6

Healthcare Customer Service Representative Resume Examples & Samples

  • Ability to perform essential job functions with high degree of independence, flexibility, and creative problem solving techniques
  • 1 – 2 years prior experience in an inbound call center and/or customer service environment; hospital patient account billing with experience or knowledge of 3rd party reimbursements from insurance companies and government payers is a plus
  • Hospital Environment may include direct patient interaction
7

Healthcare Customer Service Resume Examples & Samples

  • Answers basic clinical and program inquiries
  • Coordinates access to therapies, schedules and conducts appropriate follow-up, and facilitates access to appropriate support services
  • Follows up via phone, mail, and/or fax for missing enrollment information
  • Identifies other sources of health care coverage for patients through simple queries and use of PayerPlus database
  • Typically receives general instructions on routine work, detailed instructions on new projects or assignments
  • Performs related duties as assigned
  • Strong interpersonal skills
  • Ability to proficiently use computer and standard office equipment
  • Basic understanding of payer eligibility and benefits
  • Health care research and analysis skills sufficient to support payer research healthcare policy library and state management
  • Ability to resolve associate issues effectively and efficiently
8

Healthcare Customer Service Representative Resume Examples & Samples

  • Communicate with Patients and Patients Representatives to resolve healthcare accounts while offering excellent customer service
  • Maintain diplomacy when addressing matters escalated
  • Provide thorough, efficient, and accurate documentation and updates in all required systems for each work event
  • Responsible for meeting monthly goals and quality standards through efficient and accurate work processes
  • Review open accounts to determine and take appropriate actions through understanding charges, billed claims, payments, denials, adjustments, and refunds
  • Respond to verbal and/or written inquiries in a timely manner
  • Process all correspondences with adherence with the Health Insurance Portability and Accountability Act (HIPAA) guidelines where applicable
  • Knowledge, understanding, and compliance with company policies and procedures
  • Provide feedback to management concerning possible problems or areas of improvement
  • High School Diploma or General Educational Development (GED) certificate or equivalent in relevant work experience desired
  • Previous customer service and healthcare receivables experience preferred
  • Understanding of health insurance providers, Workers' Compensation, Medicare, Medicaid, and liability claims processes and contracts
  • Proficient personal computer skills
  • Excellent interpersonal, written, and oral communication skills
9

Healthcare Customer Service Representative Resume Examples & Samples

  • Maintain the appropriate level of work activity according to work standards and establish work processes to ensure timely certification
  • Educate patients and patient representatives on the eligibility requirements, application process, and verification requirements for applicable programs
  • Facilitate the application process when appropriate for the patient by assisting the patient in the completing of the application, scheduling appointment interviews and obtaining required verification
  • Maintain consistent proactive communication with the patient and/or patient representative throughout the eligibility process, keeping the patient informed of the accounts progress
  • Maintain a professional relationship with the patient and governmental agencies to ensure cooperation and compliance
  • Document pertinent patient information and all work activity in the appropriate systems dictated by company policies and procedures
  • Ensure accounts are processed in accordance to Eligibility Program standards, Client expectations, and federal and state regulations including but not limited to, Health Insurance Portability and Accountability Act (HIPAA) guidelines
  • Knowledge, understanding, and compliance with all applicable Federal, State, and Local laws and regulations
  • Previous healthcare coverage/ eligibility experience preferred
  • Proficient personal computer skills including Microsoft Office
10

Healthcare Customer Service Representative Resume Examples & Samples

  • Follow-up with insurance companies on billed claims regarding claim status and resolution of payments in a timely manner
  • Thoroughly review all notes in patient accounts for potential insurance benefit eligibility
  • Access client systems to determine insurance eligibility and filing status in order to prepare claims for billing
  • Request necessary documents from client to perform insurance billing
  • Responsible for accurately tracking payments and payment verifications
  • Contact patients when additional information is required to complete billing
  • Dependent upon position, identify root cause of issues and concerns, determine resolution, and refer to Management
  • High School Diploma or General Educational Development (GED) certificate or equivalent relevant work experience desired
  • Previous insurance/medical billing/customer service experience preferred
  • Proficient personal computer skills, including Microsoft Office
  • Ability to prioritize and organize work in a multitasked environment
11

Summer Internship Healthcare Customer Service Resume Examples & Samples

  • Facilitates access to appropriate support services, including reimbursement counseling, nursing hotline, and support
  • Processes incoming enrollment forms for program
  • Supports payer research, health care policy library, and state management
  • Works on problems of limited scope. Follows standard operating procedures in analyzing data from which answers can be readily obtained. Builds stable working relationships internally
  • Learns to use professional concepts; applies company policies and procedures to resolve routine issues
12

Healthcare Customer Service Representative Resume Examples & Samples

  • Maintain a professional relationship with the patient while providing excellent customer service and performing assigned duties
  • Document pertinent patient information and all account work activity in the appropriate systems dictated by the health care facility and Company
  • Responsible for capturing and documenting all pertinent patient demographic, subscriber, and insurance information (i.e.): patient Policy and ID numbers, subscriber, guarantor, payer address, phone numbers, and other contact information. Documentation must include, benefit effective date, copay, deductible, out of pocket non-covered services responsibilities, co-insurance, stop loss amounts, percentage of coverage and any other pertinent information concerning the specific procedure/clinical service to be performed
  • Responsible for securing authorizations and documenting all pertinent information (i.e.): Insurance, Ordering information, Physician information, Tax ID, CPT, HCPCS and ICD 10 codes. Documentation must include, authorization status, authorization number, ordering procedures, verified from, dates approved for and any other pertinent information
  • Responsible for meeting all patient registration goals in a timely manner to ensure time sensitive requirements are obtained
  • Working knowledge of Protected Health Information (PHI), HIPPA
  • Personally responsible, respect for self and others, innovative through teamwork, dedication to caring and excellence in customer service
  • Able to successfully schedule procedures through the identification of available times, establish accurate scheduling records and verify patient demographic and insurance information
  • Responsible for accurately obtaining and entering proper procedure or diagnosis codes into scheduling system
  • Obtains and accurately completes ABN or MSP forms, when applicable
  • Obtains complete and accurate insurance information and completes insurance verification by contacting patients, physician offices and insurance/payer regarding the visit
  • Works according to standard operating procedure during ADT/system downtimes
  • Reviews work and ensures accuracy, particularly patient type, code identification, insurance and demographic information to minimize error rate and time delays in clinical and billing departments
  • Assists patients, as needed, to ensure compliance with the payer’s requirements for reimbursement
  • Responsible for assessing financial responsibility, resources, and/or referring patients for financial counseling, if necessary, based on the individual’s financial condition according to charity policy
  • Responsible for communicating with patients regarding patient financial responsibilities before or at time of service. Informs patients on billing process for facility and providers
  • Responsible for understanding and complying with all policies, procedures, and regulations relating to job duties
13

Healthcare Customer Service Representative Resume Examples & Samples

  • Proactively contact customers using outbound calling technology
  • Actively participate in ongoing training and compliance to all state rules and regulations
  • Ensure accuracy of information collected
  • May need to follow-up and encourage customers to send back required documentation
  • Conduct effective consultative selling by asking appropriate questions and matching the right product to the customer’s needs, resulting in closed sales as well as increased customer satisfaction
  • Comply with all do-not-call and insurance regulatory standards
  • Demonstrated success in an INBOUND OR OUTBOUND SALES
  • Strong goal orientation. Must provide good examples of how they set challenging goals and strive to achieve personal success
  • Capacity to learn complex processes and policies
  • Ability to successfully take tests and retain knowledge
  • Knowledge of computer operations
  • Detail oriented with examples of how they have been able to ensure high quality work
  • Willingness to rotate shifts, as needed
  • Positive orientation: as in focused on how to achieve success, not on barriers
  • Dependable and flexible
  • Good listening and responding skills
  • Possess a drive to achieve as well as insight into self and others
14

Healthcare Customer Service Representative Resume Examples & Samples

  • Consulting with customers to review health related products and services. Discussing customer needs and assisting with the best solutions for their individual situations
  • Opening and maintaining customer accounts and information
  • Creating customer solutions with compassion by listening and selecting the best and fastest solution to customer inquiries
  • Resolving customer technical issues with patience and understanding
  • Identifying any additional needs the customer may have and helping them to upgrade products or services
  • Competitive pay plus performance-based bonuses
  • Career advancement opportunities
  • Health insurance
  • Tuition reimbursement
  • Retirement savings
  • Paid training
  • Competency in using MS Windows
  • Ability to adapt and excel in a fast-paced work environment
  • Availability to work one weekend day
15

Healthcare Customer Service Manager Resume Examples & Samples

  • Promotes, maintains, and inspires a positive work environment of trust, respect, and support for all internal/external customers, and staff by adhering to the Adventist Health’s Mission and Values, as well as the hospital performance at a higher level service and accountability strategies
  • Adheres to the Adventist Health Hospitals’ Code of Conduct at all times
  • Supervises the daily office operations and staff to ensure smooth flow, optimal productivity, and ensure that all functions adhere to providing excellent customer service in a Call Center environment
  • Ensures that all calls to department(s) meet or exceed Call Center standards of ensuring satisfactory customer service Ensures that special needs for a procedure are communicated to the appropriate department(s) and individual(s) in a timely manner
  • Support/problem solving for perform as communication liaison for both internal and external customers
  • Provides staff with any training pertinent to their job duties
  • Continuously demonstrates courtesy, effectiveness, and discretion in all communications
  • Meets as needed with staff to promote communication and teamwork regarding adhering to department service center standards, facilitation of work orders, department compliance in established safety practices and department performance improvements, staff behavior, evaluations, and counseling
  • Adheres and models all facility policies, procedures and safety practices
  • Functions as effective team member and facilitate processes within the department and organization
  • Serves on committees and work groups as requested
  • Completes other duties as assigned
  • Graduate of a college/trade school program or have a minimum of three years work experience in the medical industry
  • Knowledge of computer and one year of hands-on experience in a Call Center environment
  • Demonstrates excellence in interpersonal relationships and verbal and written communication skills
  • Demonstrates analytical ability
  • Demonstrates critical thinking and problem solving
  • Exhibits well developed organizational skills, with demonstrated initiative and judgment in call center standards and a proven record of service excellence
  • Demonstrates marketing skills
  • Demonstrates organization and self-discipline with attention to detail and accuracy
  • Identifies with mission, vision, and values, for Adventist Health
  • Possesses physical stamina, known to be hard working and able to cope with multiple internal and external pressures
  • Demonstrated high regard for the dignity and worth of patients and their families
  • Committed to upholding and providing services in a manner that is congruent with the Adventist Health’s mission statement
  • Demonstrates a flexible demeanor
16

Healthcare Customer Service Resume Examples & Samples

  • Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program
  • Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications
  • Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payors. Researches and resolves any electronic claim denials
  • Researches and resolves any claim denials or underpayment of claims
  • Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods
  • Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly
  • Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers
  • Reports any reimbursement trends/delays to supervisor (e.g. billing denials, claim denials, pricing errors, payments, etc.)
  • Processes any necessary insurance/patient correspondence
  • Provides all necessary documentation required to expedite payments. This includes demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians
  • Coordinates with inter-departmental associates to obtain appropriate medical records as they relate to the reimbursement process
  • Maintains confidentiality in regards to patient account status and the financial affairs of clinic/corporation
  • Communicates effectively to payors and/or claims clearinghouse to ensure accurate and timely electronically filed claims
  • Works on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercises judgment within defined standard operating procedures to determine appropriate action
  • Typically receives little instruction on day-to-day work, general instructions on new assignments
  • Ability to build productive internal/external working relationships
  • Strong negotiating skills
  • Strong mathematical skills
  • General knowledge of accounting principles, pharmacy operations, and medical claims
  • General knowledge of HCPCS, CPT, ICD-9 and ICD-10 coding preferred
  • Global understanding of commercial and government payers preferred
  • Ability to proficiently use Microsoft Excel, Outlook and Word
  • Is developing professional expertise; applies company policies and procedures to resolve a variety of issues
17

Healthcare Customer Service & Inbound Sales Resume Examples & Samples

  • Competitive hourly wage plus performance-based bonuses
  • Paid product knowledge, customer service, and sales training
  • 6 months of customer service or sales experience
  • Authorized to work in the Unites States
  • A desire to help people prepare for their future healthcare needs
18

Healthcare Customer Service Represenative Resume Examples & Samples

  • Access to more than 3,000 online training courses through our Kelly Learning Center
  • Weekly pay and service bonus plans
  • Important information: This position is recruited for by a remote Kelly office, not your local Kelly branch. Please submit your resume to be considered for this position by pressing the “SUBMIT RESUME” button below. Please email Kim Smith at smith22@kellyservices.com for any additional questions about the job posting
19

Healthcare Customer Service Representative Resume Examples & Samples

  • Essential computer skills on a PC or Mac
  • Basic knowledge of FDCPA
  • Ability to work with a team setting and be supportive of the team members
20

Healthcare Customer Service Supervisor Resume Examples & Samples

  • Provides regular supervision and mentorship over subordinate staff
  • Identify and address agent training needs
  • Manage team’s time entry to ensure 0% discrepancy rate
  • Manage financial implications of attrition and attendance by maintaining program-specific goals
  • Manage staffing in accordance with program specific workflow (i.e. down-staffing, up-staffing)
  • Completion of weekly Team Manager Scorecard for review with Operations Manager
  • Completion of Team Manager Onboarding
  • Establish a team environment by coordinating/cooperating with peers, sharing recognition, supporting interdepartmental and company-wide objectives
  • Objectivity, professionalism and maturity
21

Seasonal Healthcare Customer Service Representative Resume Examples & Samples

  • Identifying the prescription drug insurance program needs of the consumer
  • Recommending the RIGHT insurance package for each consumer; and
  • Complete each transaction to ensure the consumer's appropriate coverage
  • Be able to deliver exceptional support for as many as 20 consumers each and every day remembering that behind every call is real person seeking help, guidance, and support
  • Possess exceptional communication skills and the ability to create meaningful connections
  • You must be driven by integrity and a desire to deliver an exceptional consumer experience!
22

Healthcare Customer Service Rep Days / wk Resume Examples & Samples

  • Knowledge of medical terminology, health care environment, reimbursement landscape, therapeutic and product related knowledge
  • Understanding and compliance with corporate, divisional, departmental and program specific standard operating procedures
  • Community College/CEGEP education OR a recognized trade/technical certification
  • More than six months and up to one year in a previous job or jobs
  • Required to use menu-driven retrieval and search functions on Windows based applications, web-based applications and proprietary information technology systems; ability to use a switch-based telephony software, etc
  • Carries out similar tasks or activities within the work group with no management/supervisory responsibilities