Barbara Mewborn
Winston-Salem
Summary
Customer service oriented professional with front desk. healthcare industry, and military experience: Organizes and prioritizes work to ensure that all records are coded, and edits are resolved in a timeframe that will assure compliance with appropriate regulatory requirements. Work history includes 10+ years of patient care industry experience. Team player who performs at high levels of productivity in fast-paced environments without missing a deadline Strong written and verbal communication skills. Demonstrates independent work initiative, sound judgment, and attention to detail. Driven and self-motivated with strong problem-solving skills. Microsoft Office Applications - MS Excel, MS Word, MS PowerPoint: Typing Speed: 42 WPM. Certifications: CPR.
Overview
27
27
years of professional experience
Work History
Case Manager
McKesson Pharmaceutical
Irving
03.2022 - Current
- Handle inbound and outbound telephone calls.
- Adhered to HIPAA regulations and McKesson Pharmaceutical procedures and policies
- Provide excellent customer service to Patients and Insurance Providers
- EOB (Explanation of Benefits): went through the healthcare plan by reviewing the premiums, deductible, co-payments, and balance
- ICMS (Integrated Case Management System): verify patients demographics, healthcare plan, and setup accounts
- Perform verification of the patient's healthcare plan to confirm coverage and eligibility
- Utilize the Five9 Software to accept calls, monitor and record the daily schedule.
- To ensure coverage of the medication plans, an outreach to the providers is conducted
Customer Service Representative
RemX/McKesson
Phoenix
08.2021 - 03.2022
- Handle inbound and outbound telephone calls.
- Adhered to HIPAA law and McKesson procedures and policies
- ICMS (Integrated Case Management System): verify patients demographics, healthcare plan, and setup accounts
- Insurance verification: confirm the patient's coverage and eligibility
- Five9 Software: accept incoming calls and update the monitor data to record the daily schedule
- Outreach to providers to review and ensure coverage for the patients' prescription
- Process incoming prior authorizations for review and response
- EOB (Explanation of Benefits): review premiums, deductible, co-payments and out of pocket expense
Save-A-Trip Associate / Customer Service - Call Center
Walgreens
Winston-Salem
08.2020 - 08.2021
- Handle inbound and outbound telephone calls.
- Resolve questions and concerns from customers, physician offices, and third-party vendors, and use resources.
- Follow established guidelines and procedures, choose best solutions, and direct complex questions to supervisors.
- Log and track inquiries and check status of items needing follow-up or involvement of other parties.
- Document interactions, record complaints, coordinate with other areas, and reach out to providers and vendors.
Customer Service Representative - Call Center
Hanes Brand
Winston-Salem
04.2018 - 08.2020
- Took orders from customers over the phone, determined charges for services requested, and collected payments.
- Resolved customer complaints by performing activities such as exchanging merchandise and refunding money.
- Kept records of customer interactions and transactions, recording details of inquiries, complaints, and comments.
- Referred unresolved customer grievances to designated departments for further investigation.
Customer Service Representative
Bellomy Research
Winston-Salem
05.1998 - 04.2018
- Called customers regarding Duke Energy bills, obtained feedback, and ensured effective communication.
- Ensured that customers were assisted properly and that all questions and concerns were addressed while adhering to company guidelines and policies.
- Maintained high level of confidence while accessing customer accounts.
Patient Care Attendant
Novant Health
Winston-Salem
05.2005 - 03.2015
- Managed incoming and outgoing calls.
- Sat with patients, helped with daily care needs, and helped patients attain mental and physical well-being
- Documented or otherwise reported observations of patient behavior, complaints, or physical symptoms to nurses
- Lifted, moved and transported residents, utilizing proper body mechanics or lifting devices for accident prevention.
- Provided individualized attention and encouraged each resident's ability to maintain their health.
Front Desk Clerk / Cashier/Customer Service
Sleep Inn Hotel
Winston-Salem
08.2002 - 09.2005
- Greeted, registered, and assigned rooms to guests, posted charges, computed bills, and collected payments.
- Made and confirmed reservations and transmitted and received messages.
- Handled incoming and outgoing calls, answered inquiries regarding hotel, registered guests, and kept records of room availability and guest accounts.
Cafeteria Worker
United States Army
Fort Jackson
- Communicated with customers regarding specials, orders, comments, and complaints.
- Operated standard commercial kitchen equipment and followed food safety guidelines.
- Served customers in restaurant that specialized in fast service and inexpensive carry-out food.
Education
Associate of Science Degree - Medical Billing and Coding
Ultimate Medical Academy
01.2019
Skills
- Payment Posting
- Scheduling
- HIPAA Compliance
- Insurance Verification
- Insurance Claim Processing
- EOBs
- Co-Payments
- Deductibles
- Medical Billing
- Electronic Health Records (EHR)
- Medical Coding
- ICD-9
- ICD-10
- HCPCS
- CPT
- Medical Terminology
Volunteer Experience
Salvation Army, Winston-Salem, NC, Volunteer, 01/95, 02/09, Handed out Christmas gifts, passed out coats to those in need, and assisted with feeding individuals.
Key Qualifications
- Payment Posting
- Scheduling
- HIPAA Compliance
- Insurance Verification
- Insurance Claim Processing
- EOBs
- Co-Payments
- Deductibles
- Medical Billing
- Electronic Health Records (EHR)
- Medical Coding
- ICD-9 - ICD-10
- HCPCS
- CPT
- Medical Terminology
Timeline
Case Manager
McKesson Pharmaceutical
03.2022 - Current
Customer Service Representative
RemX/McKesson
08.2021 - 03.2022
Save-A-Trip Associate / Customer Service - Call Center
Walgreens
08.2020 - 08.2021
Customer Service Representative - Call Center
Hanes Brand
04.2018 - 08.2020
Patient Care Attendant
Novant Health
05.2005 - 03.2015
Front Desk Clerk / Cashier/Customer Service
Sleep Inn Hotel
08.2002 - 09.2005
Customer Service Representative
Bellomy Research
05.1998 - 04.2018
Cafeteria Worker
United States Army
Associate of Science Degree - Medical Billing and Coding
Ultimate Medical Academy
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