Healthcare Customer Service Resume Sample
Hellen Howe
54092 Bashirian Ville,
New York,
NY
+1 (555) 999 9870
Work Experience
Healthcare Customer Service Manager
08/2017
-
PRESENT
San Francisco, CA
- Strictly adheres and demands strict adherence to the company’s policies
- Answer inbound customer/client requests or inquiries concerning services, products, billing, equipment, claims, and report problem areas
- Responsible for improving customer retention through programs and exemplary service provided to the customer
- Make recommendations according to customer's needs on features, accessories, upgrades and options
- Respond to customer inquiries in a confident, timely and accurate manner
- Evaluate data to determine and implement the appropriate course of action to resolve or coordinate service recovery as needed
- Efficiently and successfully navigate multiple system
Healthcare Customer Service Representative
07/2012
-
07/2017
Los Angeles, CA
- Type 45wpm accurately
- Adheres to and participates in Company’s mandatory HIPAA privacy program / practices and Business Ethics and Compliance programs / practices
- Research caller’s issues/problems and find solutions
- Billing of claims to the appropriate party
- Follow up with Insurance timely
- Assist in resolving balances on the patient account
- Timely follow up with patients
- Correct and refile claims with the insurance
- Take patient complaints, post discounts, set up budget plans, follow up with medical records department and also provide estimates
Summer Internship Healthcare Customer Service
01/2008
-
05/2012
New York, NY
- Interact with members via telephone to respond to inquiries, complaints, appeals and/or grievances in accordance with state and federal compliance requirements and internal guidelines
- Answer a high volume of inbound calls
- Suggest and share ideas for system and process improvement
- Meet and/or exceed KPIs identified by the business
- Internal communications/requests - client, teams, and departmental
- Scheduling of meetings with team and/or client
- Utilizing our applications for case research
- Ensuring all internal processes are followed as well as remaining HIPAA compliant
- Additional responsibilities within scope of position
Education
Herzing University - Atlanta
2003 - 2008
School's Degree in Healthcare
Professional Skills
- Strong analytical problem-solving and decision-making skills
- Strong problem solving-skills and ability to think creatively to resolve issues
- Excellent telephone and PC/data entry skills
- Excellent communication and interpersonal skills
- Possesses strong work ethic and organizational skills
- Proficient typing skills; able to type with little to no errors
- Any prior experience with insurance claims billing and follow up as per DHA guidelines
How to write Healthcare Customer Service Resume
Healthcare Customer Service role is responsible for research, software, computer, basic, multimedia, insurance, digital, database, training, credit.
To write great resume for healthcare customer service job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Healthcare Customer Service Resume
The section contact information is important in your healthcare customer service resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Healthcare Customer Service Resume
The section work experience is an essential part of your healthcare customer service resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous healthcare customer service responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular healthcare customer service position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Healthcare Customer Service resume experience can include:
- Adaptability and quick learning skills
- Most of our members are Sr. Citizens (Sexagenarian)and effective and empathetic communication is a critical skill for this role
- Develops mentor skills to assist colleagues and/or team members
- Intermediate knowledge of computer applications and navigation skills
- Basic Microsoft skills (Excel)
- Computer literacy / data entry skills are required and proficiency in Microsoft Word, Outlook, and Excel
Education on a Healthcare Customer Service Resume
Make sure to make education a priority on your healthcare customer service resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your healthcare customer service experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Healthcare Customer Service Resume
When listing skills on your healthcare customer service resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical healthcare customer service skills:
- Strong computer skills and verbal communication
- 1-2 years pharmacy benefits experience and/or call center experience
- Verbal communication skills (English and Arabic)
- Customer service experience, phone base and retail experience are welcome
- Windows computer systems skills and ability to learn new programs as required
- Detail-orientation and ability to multitask effectively in a fast-paced environment
List of Typical Experience For a Healthcare Customer Service Resume
1
Experience For Healthcare Customer Service Representative Resume
- Obtains prior authorization and secures co - pay as defined by policy
- Previous experience as an admin or customer service representative (preferably in medical/healthcare)
- Experience with image display software and web-based data entry software
- Type and operate computer
- Demonstrates professionalism by appearance, action, self-development, and guest relations
- Experience in customer service and/or call center
- Experience in a healthcare office environment
- Medical knowledge or experience
- Answering and routing of inbound calls
2
Experience For Healthcare Customer Service Manager Resume
- Research and resolve patient accounts which adversely impacts account resolution and revenue
- Answer inbound customer service calls and make some outbound follow up calls in a professional, service oriented manner
- Answer the calls timely without drops/abandons
- Provide ePayables support to various providers as well as cross sell them on the benefits
- Interpret benefit eligibility based on Summary Plan Descriptions
- Contact providers, clients and insurance carriers as needed
- Research written and verbal inquiries in response to complex customer calls
- Maintain updated documentation on calls received and made
3
Experience For Healthcare Customer Service Supervisor Resume
- 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
- Respond to customer inquiries by phone and written correspondence
- Assist with questions related to insurance benefits, provider contracts, eligibility and claims
- Research information from database
- Document activities and outcomes
- Place follow-up calls as needed
- 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
- 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
4
Experience For Seasonal Healthcare Customer Service Representative Resume
- Adheres to the Adventist Health Hospitals’ Code of Conduct at all times
- Promotes and recommends our client’s products and services based on customer's needs and interests
- Daily reconciliations of customer accounts
- Request account updates and adjustments
- Process a high volume of claims each day
- Customer and internal staff support re new orders, returns, back orders issues, other inquiries
5
Experience For Healthcare Customer Service Rep Days / wk Resume
- Escalate as required to the customer service manager
- Work to attain KPI goals related to calls, orders, and returns
- Processes coverage determination requests received by mail, fax, electronic portal or telephone
- Responds to inquiries from customers for information and assistance related to coverage determinations
- Seeks assistance with complex customer services issues
- Maintain the strictest confidentiality in accordance with all HIPAA guidelines/regulations
- Stay abreast of code changes, updates to reimbursement guidelines, and coverage policies
6
Experience For Healthcare Customer Service & Inbound Sales Resume
- Provides quality information and accurate solutions for a defined scope of customer issues via telephone and email correspondence
- Maintains phone time and/or electronic service goals every day
- Determines when customer issues need to be escalated, and uses appropriate channels to timely resolution
- Provides information to health insurance brokers or agents on ID, password and address change requests
- Knowledge of Microsoft Office, specifically Excel, Word, and Outlook Exchange; proficient in Internet Explorer or Chrome
- Read, analyze and interpret Explanation of Benefits (EOB)
7
Experience For Summer Internship Healthcare Customer Service Resume
- Conduct effective consultative selling by asking appropriate questions and matching the right product to the consumer’s needs, resulting in closed sales as well as increased consumer satisfaction
- Obtain pre-authorization for exams and procedures
- Coordinate post-consultation exams and appointments
- Maintains detailed records of information gathered and authorizations issued and extended: this is done by entry into the DST Health Connect system/EPIC template. Udate and manage selected databases and directories
- Production of authorization letter to providers, memebers and facilities from DST system
- Coordinate resouces and schedules
8
Experience For Healthcare Customer Service Represenative Resume
- Assist members on Medical claims related inquiries
- Provide resolution to customer queries and inquiries in a simple, concise and empathetic manner
- Perform to meet customer and business defined performance goals
- Adherence to assigned operational shift and work schedule
- Buddies up with co team member to increase overall efficiency of the co team member as required by the Team leader
- Participate on improvement projects as part of individual development plan and in accordance with business need
- Manage inbound and outbound phone activity from multiple accounts and end users for order placement, order tracking, insurance verification and all other related insurance inquiries, medical billing
- Work in collaboration with Operations and Logistics to determine the delivery of shipments/ supplies
9
Experience For Healthcare Customer Service Resume
- Work in collaboration with Medline Sales and Reimbursement for proper implementation
- Identify trends and communicate results to the management staff, sales force, and the customer
- Utilize multiple tools and resources for account, program, and insurance related inquiries
- Take inbound and place outbound calls in a call center environment
- Resolve client issues and respond with prompt follow up to clients as needed
- Process all related documentation and paperwork as needed
- Responsible to provide quality, professional service in all customer interactions
- Accurately provide benefit information and claim status to callers
- Maintain 98% Accuracy on all patient documentation and referral information in patients account
10
Experience For Healthcare Customer Service Representative Resume
- Routes referral and patient information to the appropriate venue and notifies referral source of disposition when unable to accept referral
- Resolves questions and problems, and refers only the most complex issues to higher levels
- Adhere to all written policy and procedures
- Outbound Calls (20%): typically consist of contacting your client’s patients to discuss their outstanding medical bills. Goal is to set-up payment arrangements or collect a payment in full
- Provide a compassionate and people-centric consumer experience that focuses on
- Take the onsite paid study course route
- All books, materials, and resources are included
- Earn $14/hr as a Seasonal Healthcare Customer Service Representative
List of Typical Skills For a Healthcare Customer Service Resume
1
Skills For Healthcare Customer Service Representative Resume
- Exceptional interpersonal, communication (both oral and written), organizational, and time management skills
- Experience assisting peers and acting as a lead
- Handle 35+ calls and 15+ referrals during an 8 hour shift, facilitating a positive patient experience
- Experience with Microsoft Office products including Word, Excel, Outlook
- Experience using Microsoft Office Suite products Word, Excel and Outlook
- Adapt to change and be flexible in shifting priorities
- Good understanding UAE healthcare insurance RCM
2
Skills For Healthcare Customer Service Manager Resume
- Provides quality customer service for issues regarding employee enrolment changes, ID card status, and effective date inquires
- Possess a good understanding of HIPAA laws and guidelines
- Data entry or customer service experience
- Customer service experience in a high volume call center or healthcare environment
- Customer service experience in a healthcare environment
- Experience within role, at least 1 year
3
Skills For Healthcare Customer Service Supervisor Resume
- +2 years customer service experience in an inbound/outbound call center environment
- Customer Service Experience VERY IMPORTANT, in person AND over the phone
- Demonstrated ability to work in a team-based environment
- Computer experience preferably in a PC windows based environment
- Documentation of customer experience as well as any additional data
- Address/resolve complaints and service issues in a professional and effective manner
- Testing & licensing fees are waived
- Understanding and thorough knowledge of retiree medical benefits, including Medicare and Part D
- Mailing/faxing requested correspondence as needed
4
Skills For Seasonal Healthcare Customer Service Representative Resume
- Processing new orders and ensuring that deliveries are on time
- Willing to learn new tasks and adapt to new business requirements
- Resolving payment discrepancies and delinquencies
- Facilitating communications across all lines of business and with other departments
- Scheduling appointments for consultations, exams and procedures
- Processing requests for specialty, therapy or complex appointments and exams
- Typing speed - min 20 - 30 wpm and >90% accuracy
5
Skills For Healthcare Customer Service Rep Days / wk Resume
- Assist with placing, replacing, crediting, and tracking, orders received via email and or fax
- Responsible for promoting and selling client’s products and services by emphasizing product features based on analyses of customers’ needs
- Proficiency in math, data entry, typing, spelling and grammar, for which tests are required
- Obtain your State Life & Health Insurance License FREE of cost - a $1,100 value (starting as early as July 2017) including
- Complete 3 weeks of additional, paid product and sales training (starting in September)
- Committed to upholding and providing services in a manner that is congruent with the Adventist Health’s mission statement
- Medical terminology, ICD coding and CPT coding knowledge
- Actively participates in regular team meetings, providing input to contribute to the team’s overall success in achieving customer satisfaction
- Assist in identifying and data gathering for potential COB cases
6
Skills For Healthcare Customer Service & Inbound Sales Resume
- Work in collaboration with team members to ensure the service needs of Homecare CS customers are being met with outstanding service levels
- Answer questions pertaining to retiree benefits, including Medicare and Part D plans
- Meets all monthly sales objectives by approaching sales as a way of helping our client’s customers receive the best value for their money
- 11 days of paid instructor supported classroom training
- Need to be able to work a flexible schedule including nights and weekends
- Be seeking a long-term role, in the customer service / health insurance industry
7
Skills For Summer Internship Healthcare Customer Service Resume
- Possess high productivity and quality standards within a claims processing automation environment
- Knowledge on Medical Billing terminology
- Microsoft Applications including Word and Excel
- Function independently and multi-tasking
- Relays general information to callers regarding the facility
- Handle inbound and outbound calls from customers regarding their benefit plans
- Proficiency in managing multiple tasks
- Working knowledge of the adjudication process
8
Skills For Healthcare Customer Service Represenative Resume
- Understanding of the complete healthcare revenue cycle
- ) working in a call center environment
- Proficiency in MS Office applications, including Word, Excel and Outlook
- Take the unpaid study course without leaving your home
- Handle incoming and outbound group health plan customer service calls
9
Skills For Healthcare Customer Service Resume
- Answer questions concerning claims status, medical pre-certification and ePayment
- Provide technical support for patient-facing applications
- Participates in provider education regarding policies and procedures
- Serve and educate members by providing information related to their plan coverage and benefits
- Proficiency in using written and verbal positive language
- Work in collaboration with 3rd Party Billing Partners for insurance related inquiries
- Provides mentorship to other representatives during introductory period
- Credit returns and disputes handling
10
Skills For Healthcare Customer Service Representative Resume
- Works in various queues to ensure proper handling of all processes related to coverage determination requests
- Makes outbound notification calls to members and/or their appointed representatives regarding status of requests
- Answer patient, client, or insurance carrier questions regarding claims
- Digital imaging management
- Self-motivator, detail oriented, and willingness to adapt to department and company needs
- Understand oral and written directions
List of Typical Responsibilities For a Healthcare Customer Service Resume
1
Responsibilities For Healthcare Customer Service Representative Resume
- Intermediate - Advanced proficiency in computer skills and aptitude such as but not limited to MS Office application, email, Internet Explorer, etc
- Have 1-3 years of recent customer service experience
- Experience within a call center
- Customer service experience in a professional office environment
- Experience in Customer Contact Role
- Be able to multitask, and type while speaking
2
Responsibilities For Healthcare Customer Service Manager Resume
- Willingness to work from different hospital
- Call center or customer service office environment
- Health examination at time of hire
- Flexible; able to work weekends & holidays & overtime
- Microsoft Suite (Word, Excel, Outlook, PowerPoint)
- Customer service in an actual 'Call Center'
3
Responsibilities For Healthcare Customer Service Supervisor Resume
- Recent medical office or healthcare
- Knowledge of and standard insurance verification processes
- Answers calls from customers and place customer calls
- Proficiency with Microsoft Outlook, Microsoft Word and Microsoft Excel, fax machines
- Meet deadlines in fast-paced environment
- Work independently and be reliable
- Benefits Verification Specialist
4
Responsibilities For Seasonal Healthcare Customer Service Representative Resume
- Patient Services Representative
- Explain benefit determinations
- Sales call center knowledge
- Possesses a positive and supportive attitude towards all internal and external customers
- Conducts reminder call backs
- Type verbal/written information into the computer
- Speak on the phone and use a computer
- Use logic and solve problems
5
Responsibilities For Healthcare Customer Service Rep Days / wk Resume
- HS Diploma or GED Equivalent
- Qualified candidates have strong call center, data entry, or office based experience, comfortable with production based work, preferably in a healthcare environment
- Knowledge of US Health Insurance Industry standards
- Navigate and toggle between multiple screens
- Previous pharmacy technician experience highly desired, certification or license highly desired and/or related PBM business experience with knowledge of long term care pharmacy billing
6
Responsibilities For Healthcare Customer Service & Inbound Sales Resume
- Flexibility in work schedules, 20 - 29 hours/week
- For more information on the TTEC experience, visit http ://www.ttecjobs.com or search #ExperienceTTEC throughout social media to experience the global conversation for yourself
- Process provider referrals
- Basic healthcare knowledge
- Patient Access Specialist
- High attention of detail
- Be proficient with Windows based computers, and Microsoft Office software
7
Responsibilities For Summer Internship Healthcare Customer Service Resume
- Be able to speak professionally with clients, be able to de-escalate and resolve conflicts
- Be able to commute to the Nashville/Airport area
- Be able to report to work reliably
- Knowledge of drug therapies. (Generic/Brand names, drug classes, signs)
- Work in a team environment and promote teamwork
- Directs and/or manages all activities associated with Call Center operations. Maintains and enhances customer services by organizing and evaluating service, delivery systems and procedures. Supervises a staff of employees, working to develop and coach talent to ensure the successful operation of the team and organization
8
Responsibilities For Healthcare Customer Service Represenative Resume
- Additionally, customer service receives multimedia contacts from retail and long term care pharmacies requiring claims processing assistance, reimbursement disputes, and contract requests
- Career advancement opportunities / Promotion from within
- Conscientious and customer focused
- General knowledge of formulary process, and branded versus generic drugs required
- Criminal history background screen required upon formal job offer
- Preference given to those with job tenure
- An ability to adapt and excel in a fast-paced work environment
9
Responsibilities For Healthcare Customer Service Resume
- Data Intake Specialist
- Be part of a team
- Use computer software with ease
- Speak fluently in Spanish
- Develops skills and actively seeks information to understand customer's circumstances, problems, expectations, and needs. Shares and/or conveys information to customers maintaining a professional demeanor in all situations
- Interacts with customers to provide information in response to routine inquiries about products or services
10
Responsibilities For Healthcare Customer Service Representative Resume
- Becomes familiar with policies and procedures, as well as the business and organization. Complies with company and regulatory guidelines
- Interact with customers via phone and email
- Make outbound phone calls to customers to follow up with additional benefits information
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