Judith Dahl

Healthcare Customer Service Representative with 7+ years customer service and billing experience in high call volume in a call center atmosphere and Demonstrates expertise in benefits verification, denials, appeals, eob interpretation and using a multi-system work flows to protect revenue and improve billing accuracy, payer negotiation and focus on patient communication, and time-management skills, with a focus on expanding in customer service interaction with and integrity. Explanation of patient billing for patients to understand the billing process and how they were billed for services and any denials they receive.

Healthcare Customer Service Representative - R1 RCM

(2024-12 - 2026-01)

• Improved customer satisfaction by resolving inquiries promptly and reducing repeat calls with clear guidance.
• Designed a concise call-routing script that reduced average handle time for complex calls.
• Escalated unresolved denials to the appeals team with compiled EOBs and claimant summaries.
• Negotiated payment with patients for a payment plan and documented terms of the plan
• Collected documented consent and payment preferences during calls, establishing billing plans for delinquent accounts.
• Coached callers through benefit breakdowns and patient responsibility
• Resolved complex patient billing disputes by reviewing EOBs and negotiating payment arrangements by phone.
• Verified patient demographics and insurance eligibility
• Handled refund requests by researching transaction histories and issuing reconciliations per company policy.
• Explained payment plan options to patients, documented terms in the account, and obtained consent.
• Validated insurance coverage by contacting payers and updated account notes with verification details.
• Prepared and submitted denial documentation with organized EOBs and claimant summaries for appeals.
• Managed outbound follow-up calls to collect missing insurance information and updated accounts with verification details.

Patient Care Representative - Scripps Healthcare

(2023-12 - 2024-10)

• Answered high volume of calls daily for patients, doctors offices, pharmacies and any other
• Validated patient insurance benefits at registration, obtained required authorizations to prevent claim delays.
• Resolved patient billing inquiries by researching account notes and correcting coding errors to clear balances.
• Updated and maintained patient demographic records in EHR, reduced duplicate charts and improved recorded the
• Updated electronic patient records daily, merging duplicate charts and improving chart completeness for clinicians.
• Communicated billing statements to patients by phone, clarifying charges and arranging manageable payment plans.
• Collected co-pays and posted electronic payments in the EHR,
• Investigated billing disputes by reviewing encounter notes and corrected coding to clear account holds.
• Processed prior-authorization paperwork through insurer portals to prevent scheduling denials for procedures.
• Resolved billing disputes by auditing encounter notes and correcting coding to clear account holds.
• Investigated complex account discrepancies, traced source entries, and corrected ledger errors to restore billing accuracy.
• Resolved billing inquiries by auditing encounter notes and submitting corrected CPT codes.
• Reviewed encounter notes to identify coding mismatches, submitted corrections and cleared account holds for billing.
• Verified insurance benefits via payer portals before procedures, preventing scheduling denials at registration.

Benefit Verification - Navient Healthcare

(2021-02 - 2023-09)

• Contacted members to obtain missing enrollment documents and updated records to resume benefit processing, improving completion rates.
• Investigated denied claims by reviewing explanations of benefits and compiled concise issue summaries for carriers to expedite claim resolution
• Answered member inquiries about verification status via phone and reduced follow-up calls through clear guidance.
• Coordinated with carriers on document acceptance criteria and recovered member benefits access.
• Answered complex verification calls and clarified next steps, reducing repeated member outreach.
• Designed a triage workflow that prioritized time-sensitive verifications to reduce prolonged member coverage gaps.

High School Diploma - Harrison High School (1984-09 - 1987-05)