COURTNEY PEACE
Henderson
Summary
Dedicated and professional individual excelling at identifying the most effective course of action in various scenarios. With a proactive approach, quickly assesses and addresses challenges. Demonstrates confidence and handles tasks with a highly organized approach, whether working independently or as part of a team. Strong advocate for those in need, committed to providing the best possible service.
Overview
11
11
years of professional experience
Work History
Program Specialist
Care Services
09.2021 - Current
- Handled 60-70 inbound and outbound calls a day
- Served as an expert on reimbursement issues
- Completed medical and/or pharmacy benefit investigations
- Identified and requested submission of required documentation for payer/plan
- Reviewed for prior authorization, step edit identification, and appeals according to program standard operating procedures
- Maintained knowledge and understanding of the different types of major payers including private, commercial, and government insurances
- Determined coverage availability and coordinated the final aspects health care services to ensure patients have access to prescribed therapy
- Maintained a high level of ethical conduct regarding confidentiality and privacy
Patient Services Representative
Affordable Care
02.2020 - 03.2021
- Answered incoming calls from customers interested in receiving services from Affordable Dentures and Implants
- Assisted patients with scheduling appointments to be seen for extractions, implants, adjustments and relines on dentures
- Provided referral to patients for dentist office in their area that offered routine dental work as far as cleanings, fill-ins, etc
- Provided price ranges for services to patients
- Sent messages to practices on behalf of patients
- Used two computer monitors and multiple systems to assist callers while actively listening
Customer Service Representative
nThrive
05.2018 - 01.2020
- Collected money for emergency visits, procedures, and/or doctor appointments
- Assisted patients with setting accounts on payment plans and collected insurance information to submit a claim to insurance companies
- Went over itemized billing with patients, explaining any medical terminology the patient was unfamiliar with
- Researched denied claims, conducted coding reviews of medical records, and supported documentation against denied claims
- Resubmitted claims with accurate coding
- Corresponded to patient and physician's questions regarding EOB's, patient balances, co-pays, deductibles, write-offs, etc
- Worked with Medicaid, Medicare, Commercial Insurances and Worker's Comp Insurances
- Recognized patterns of inconsistent and/or inaccurate claims filing and billing practices among customers and providers
Customer Service Representative
Infinity Marketing
07.2016 - 01.2018
- Provided troubleshooting assistance to Verizon customers
- Ensured productivity met or exceeded service and quality standards
- Responded to escalated calls from customer service regarding issues with cell phones, tablets, accessories, service, etc
- Researched denied claims and supported documentation against denied claims
- Accepted and implemented feedback to achieve individual and team performance goals
- Maintained expectations regarding call quality and resolution time
- Utilized multiple computer screens and computer systems
Customer Service Representative
Xerox
09.2014 - 04.2016
- Ensured productivity met or exceeded service and quality standards
- Adhered to HIPAA policies and protocols, becoming HIPAA certified
- Navigated through multiple computer applications with speed and accuracy
- Provided support for pharmacy information management system to retail pharmacy employees
- Answered incoming chats from employees
- Explained copays, deductibles, coinsurance, and out of pocket maximum to members
- Called other insurance companies and healthcare physicians on behalf of members per the company
- Recognized patterns of inconsistent and/or inaccurate claims filing and billing practices among customers and providers
Education
Phlebotomy Technician
Medical Careers Readiness of North Carolina
Henderson, NC03-2025
High School Diploma -
Southern Vance High School
01.2013
Skills
- Microsoft Office Proficiency
- HIPAA Certified
- Medical Terminology
- Claims/Payment Management
- Type 40 WPM
- Analytical Skills
- Communication Skills
- Interpersonal Skills
- Multitasking Skills
- CPT & ICD-10 Coding
Languages
English
Timeline
Program Specialist
Care Services
09.2021 - Current
Patient Services Representative
Affordable Care
02.2020 - 03.2021
Customer Service Representative
nThrive
05.2018 - 01.2020
Customer Service Representative
Infinity Marketing
07.2016 - 01.2018
Customer Service Representative
Xerox
09.2014 - 04.2016
Phlebotomy Technician
Medical Careers Readiness of North Carolina
High School Diploma -
Southern Vance High School
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