Asia Cook
Metairie
Summary
Dynamic and empathetic customer service specialist with a passion for delivering memorable experiences to every client interaction. Possessing a solid background in resolving inquiries promptly and effectively, while maintaining a friendly and professional demeanor. Proven ability to adapt to various situations and exceed expectations in fast-paced environments.
Overview
8
8
years of professional experience
Work History
Healthcare Customer Service Representative
Lincare
05.2022 - 02.2025
- Successfully manage a high volume of inbound and outbound calls, following communication scripts and effectively handling various topics, acting as a liaison between the company and its customers
- Evaluate all documents to ensure that accurate and necessary information has been obtained for billing purposes, maintaining attention to detail and adhering to established guidelines
- Handle patient inquiries, referral source communications, and administrative department inquiries, providing prompt and courteous assistance to address their concerns and provide necessary information
- Communicate with insurance companies and process prior authorization requests, ensuring proper documentation and adherence to insurance guidelines and requirements
- Enter and update patient information accurately and efficiently into the customer information system, maintaining data integrity and confidentiality
Call Center Customer Support Specialist
Sutherland
11.2020 - 05.2022
- Followed established communication scripts and guidelines to effectively assist customers with a wide range of inquiries, such as product information, troubleshooting, order status, and account-related questions
- Acted as a knowledgeable resource for customers, providing accurate and up-to-date information about products, services, promotions, and company policies
- Utilized active listening skills to understand and empathize with customer needs and concerns, ensuring a personalized and customer-centric approach to problem-solving
- Documented customer interactions, inquiries, and resolutions accurately and thoroughly in designated systems or software, maintaining organized and up-to-date records
- Assisted customers with resolving issues and provided appropriate solutions or recommendations, going above and beyond to ensure customer satisfaction
Medical Claims Examiner Specialist
E-Health (Contract)
11.2019 - 11.2020
- Reviewed medical insurance claim forms and supporting documentation in a thorough and meticulous manner, ensuring accuracy, completeness, and adherence to insurance policies and guidelines
- Analyzed medical records, bills, and relevant documents to evaluate the appropriateness of services rendered and the eligibility of expenses for coverage, utilizing my extensive knowledge of medical terminology, procedures, and coding systems
- Verified patient and provider information, including demographics, insurance coverage, and policy details, to ensure precise claim processing and accurate reimbursement calculations
- Applied my comprehensive understanding of medical coding systems, such as ICD-10 and CPT, to accurately assign appropriate codes to medical procedures, diagnoses, and treatments, ensuring compliance with coding guidelines and industry standards
- Conducted detailed investigations and assessments of claims to identify potential fraudulent or abusive practices, collaborating with fraud investigators and legal teams as necessary to protect the integrity of the insurance system
Billing and Reimbursement Specialist
Iqor
02.2017 - 09.2019
- Reviewed patient medical records, documentation, and encounter data to accurately capture and assign appropriate medical codes, such as ICD-10 and CPT codes, ensuring compliance with coding guidelines and regulatory requirements
- Generated and submitted claims to insurance companies, government payers, and other third-party payers using electronic billing systems or paper-based methods, adhering to specific billing requirements and timelines
- Verified patient insurance coverage, eligibility, and benefits to determine the appropriate billing and reimbursement processes for each claim
- Resolved billing discrepancies, such as coding errors or missing information, by collaborating with healthcare providers and insurance companies, clarifying details, and making necessary adjustments
- Followed up on submitted claims, tracked payment statuses, and initiated appeals or inquiries when necessary to ensure timely and accurate reimbursement
- Reviewed and interpreted Explanation of Benefits (EOB) statements and remittance advice to reconcile payments, identify underpayments, denials, or non-covered services, and take appropriate actions
Education
High School Diploma -
McDonogh 35 Senior High School
Skills
- Customer Service
- Communication
- Problem Solving
- Adaptability
- Active Listening
- Empathy
- Time Management
- Organizational Skills
- Attention to Detail
- Conflict Resolution
- Multitasking
- Documentation
- Data Entry
- Billing and Reimbursement
- Insurance Claims Processing
- Medical Terminology
- Medical Coding (ICD-10, CPT)
- Fraud Detection
- Compliance
- Call Handling
- Product Knowledge
- Troubleshooting
- Account Management
- Relationship Building
- Information Management
- Prior Authorization
- Data Integrity
- Confidentiality
- Problem Escalation
- Electronic Billing Systems
- Claims Review
- Reimbursement Calculation
- Investigative Skills
- Patient Assistance
- Accuracy
- Timeliness
- Appeals and Inquiries
- Remittance Advice
- EOB Interpretation
- Payment Reconciliation
Personal Information
Title: Representative
Timeline
Healthcare Customer Service Representative
Lincare
05.2022 - 02.2025
Call Center Customer Support Specialist
Sutherland
11.2020 - 05.2022
Medical Claims Examiner Specialist
E-Health (Contract)
11.2019 - 11.2020
Billing and Reimbursement Specialist
Iqor
02.2017 - 09.2019
High School Diploma -
McDonogh 35 Senior High School