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@audreykolbert
Experienced healthcare professional with extensive call center expertise.
I am a dedicated healthcare professional with over 16 years of experience in customer service and call center operations, specifically within the healthcare industry. My expertise includes daily use of EMR systems such as EPIC and eClinicalWorks, as well as a strong understanding of medical terminology and coding systems like ICD-10 and CPT. I have a proven track record of managing performance metrics and leading teams to exceed customer service goals.
Throughout my career, I have held various roles, including Claims Customer Service Team Lead and Quality Auditor, where I honed my skills in auditing, training, and performance management. My ability to navigate complex medical claims and provide exceptional service has been recognized consistently, and I take pride in my attention to detail and commitment to quality. I am HIPAA certified and have experience in medical billing and revenue cycle management, making me a well-rounded candidate for any healthcare-related position.
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Work history, roles, and key accomplishments
Texas Oncology RPM Staffing
Feb 2025 - Present (9 months)
Reviewed medical records for new patient appointments and entered referral information into leading reach software to facilitate patient referrals to specialists. Answered inbound calls from patients and insurance companies regarding patient coverage and updated patient demographics.
R1-RCM
May 2024 - Present (1 year 6 months)
Researched and followed up on open accounts with outstanding balances to hospitals for services rendered, utilizing EMR Epic system to validate or dispute charges. Made outbound calls to settle outstanding accounts, processed payments, and provided detailed explanations of hospital bills.
QTC
Oct 2023 - Present (2 years 1 month)
Received inbound calls from providers and third-party scheduling companies to assist with VA patients' case management, following SOPs for technical issues on the Provider Portal or Virtual Medical Appointments. Scheduled, rescheduled, and authorized appointments/procedures, and updated provider credentials.
WellMed Medical Management Optum Service
Jan 2021 - Present (4 years 10 months)
Utilized Microsoft Excel spreadsheets daily to track and verify department production, auditing inbound calls to ensure quality standards were met. Provided feedback on audits, created/updated SOPs and Job Aids, and assisted with Data Entry Quality.
WellMed Medical Management Optum Service
Jan 2020 - Present (5 years 10 months)
Monitored team's daily real-time metrics, initiated and monitored Teams Chat for assistance, and provided coaching based on Quality Audits. Generated and executed Weekly Team Meetings and monthly one-on-one quality meetings.
WellMed Medical Management Optum Service
Jun 2016 - Present (9 years 5 months)
Answered incoming calls from providers and third-party billing, assisting with medical claims details and explaining Explanation of Payment/Bill. Verified benefits, updated patient files, and researched medical claims to validate disputes.
Aetna
Nov 2014 - Present (11 years)
Answered inbound calls regarding benefits, insurance claims, coverage, and disputes, verifying and providing benefits eligibility. Assisted with scheduling appointments and procedures, and managed intake/authorization requests after reviewing medical records.
Degrees, certifications, and relevant coursework
In Progress, Business Administration
Grade: 3.9
Currently pursuing a degree in Business Administration, focusing on core business principles and practices. Maintaining a strong academic record with a GPA of 3.9.
Certified Medical Assistant, Medical Assisting
Grade: 3.9
Completed a comprehensive program in Medical Assisting, gaining certification in the field. Achieved a GPA of 3.9, demonstrating strong understanding of medical procedures and administrative tasks.
High School Diploma, General Studies
Successfully completed high school education.
Software and tools used professionally
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Message AudreyTHALIA AYOUB
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