MARIA A NIELSEN

*** ********** **

Easley, SC ***40

815-***-****

Highlights:

Professional with forty three years experience as an employee within the insurance industry pertaining specifically for services received by the patient for: medical; dental; disability; adjustor; auditor; customer service representative; medical and billing coder for physicians and hospitals; computer operator, coordination of benefit (COB) representative.

Experience:

Customer Service Representative I

Concentrix February 2018 – August 2018

2000 Wade Hampton Boulevard

Greenville, SC 29615

Adjudicate Medicare Claims; Major Medical; Indemnity; Surgical Fee Schedule Plans; Review and expedite escalated claims

sent from Customer Service Department. Locate Policy Schedule's to determine benefits and review past history from previous company

to determine if duplicate(s) and previously paid by prior carrier.

Cashier Sales Associate; Key Holder

Dollar General Dollar General November 2017 – 01/13/2018

Providing exceptional Customer Service in a retail enviornment. Night/Day Key Holder regarding: Management of Sales and Cashier's;

stocking; Inventory assessments; set up of new merchandise/displays; maintain store appearance; and assistance of Customer requests;

deposit cash with receipt and obtain amount required for providing required amounts for next each register according to corporate

guidelines; submit employee's hours worked for payroll; manage independant vendor's for inventory tracking pertaining to actual receipt &

or returns & providing invoices to the corporate office; opening/closing store regardless of my designated shift. Responsable for security;

loss assessment's; inventory tracking & re-ordering; responsible for delivery of merchandise from the distribution center from the company

and assignment of merchandise being restocked including special displays for events if any at time of delivery.

Claims Processor

Concentrix July 2016 – June 2017

2003 Wade Hampton Boulevard

Greenville, SC 29615

Adjudicate medical & hospital claims

Customer Service Representative January 2015 – May 2016

Greenville Health Systems

7 Independance Pointe Ste 140

Greenville, SC 29615

Review patients account for the balance for collection of physician charges. Documentation of account advise patient of current issue and return calls to

patient for appeals request by patient. Obtain and apply payments to balance on account. Provide the end of the day reports of payments taken for

patient's account to my supervisor and manager.

ED Patient Registration June 2013 – June 2014

Rockford Memorial Hospital Rockford, IL 815-***-****

Obtain accurate demographic information from emergency room patients. Assure prompt payment of customer bills by obtaining correct financial information. Responsible for collections and financial screening.

Customer Service Associate April 2012 – September 2012

Alpine Access Denver, CO 303-***-****

Answering incoming calls from home via online on-line portal of the company's call Center Department regarding Dental Claims. To Advise status of Dental Charges of patient's account; efficiently and accurately as well as any follow-up required to resolve the patient's account(s).

Service Clerk May 2011 –December 2011

Walgreen Drug Store

Machesney Park, IL

Provided exceptional customer service in a retail environment. Maintained store stock and performed monetary transactions for customers

Web Scan Clerk January 2008 – July 2008

Integrated Home care Services Inc

Rockford, IL 815-***-****

Claims Adjuster June 1999 – October 2006

IAC/Health Plan Administrator

Rockford, IL 815-***-****

Reviewed medical records:document patient’s history; adjusted and audit medical benefits for all medical provider's; complete final determination according to patient's benefit's; appeal's for determination of patient's responsibility with written documentation.

Adjuster/Auditor; Customer Service Representative Rockford Health Plans Inc February 97 – January 1999

Rockford, IL 815-***-****

Process and audit medical claims. Respond to phone/written inquiries regarding policy benefits

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