Healthcare Administrative Assistant | CSR | Graphic Designer

I was responsible for providing patient's healthcare insurance information to physicians around United States in compliance with company policies and industry regulations. My key responsibilities included: - Providing insurance coverage: Such as patient coverage details, including benefits, copayments, and deductibles. - Maintaining accurate records: Updating and maintaining detailed records of insurance information, ensuring all data was current and accurate. - Assisting Physicians: Providing support to providers by answering their questions and addressing their concerns regarding the patient's insurance coverage, helping them thru out claims, authorization and referrals. - Collaborating with team members: Working closely with colleagues in other department to ensure a seamless and efficient process. - Specialized with Claim Denials: Know how to resolve denials such as Duplicate claims, improper billing of codes related to hcpcs codes, modifier, diagnosis codes or National Drug Code - Knowledgable on various EMR/EHR tools that can help to resolve claim denials such as: Cotiviti and Mckesson - Other software I used: Availity, Horizon BCBSNJ Portal and Evicore - HIPAA Trained: Strictly follows HIPAA guidelines to ensure standards to protect individuals medical records and other personal health information. - Knowledgable in Medical Terminology on how hcpcs codes, modifier or diagnosis codes works. Known on how to check if rendering provider is eligible to render the service to avoid denial on claims. - Expertise on checking if authorization or referral is needed. - Handled various of Healthcare Insurance plans: Medicare, PPO, POS, Advantage EPO, HMO.

Handling Inquiries - Addressing customer questions and concerns about billing via phone. Resolving Issues - Providing solutions to problems, troubleshooting product or service issues, and ensuring customer concerns are resolved. Retention & Sales - Saving customer who wants to cancel their subscription by giving discounts and other option that suits there budget and needs Order Processing - Assisting customers with placing orders, tracking shipments, and managing returns or exchanges. Maintaining Records - Keeping accurate records of customer interactions, transactions, and feedback. Providing Information - Offering detailed information about products, services, policies, and procedures. Customer Support - Offering technical support or guiding customers through troubleshooting steps. Building Relationships - Establishing and maintaining positive relationships with customers to encourage repeat business and loyalty. Feedback Collection - Gathering customer feedback to help improve products, services, and customer experience. Handled telco account: Selling Mobile phone, Internet, Telephone and Home Security Graveyard Shift: Us based customers