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Administrative Assistant Claims Examiner

Location:
Columbia, SC
Posted:
April 14, 2023

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Resume:

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BETTYE Y. MORRIS

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

Columbia, SC 29203

803-***-****

adwjlf@r.postjobfree.com

EDUCATION

University of South Carolina

Columbia, South Carolina

Attended: January 2001 to August 2005

Career Institute

Paralegal Certificate

Philadelphia, Pennsylvania

Graduated: June 1991

RELATED PROFESSIONAL EXPERIENCE

DOMINION ENERGY 11/2008 to 11/2021

SCANA CORPORATION, Columbia, SC

Administrative Assistant III, Marketing and Communications Department Provide administrative support to Executive Vice President, Director of Marketing and Managers of the Marketing Department. Coordinate schedules and travel plans for Officers. Produce budget reports and prepare monthly variance reports for the Marketing Department. Prepare PowerPoint presentations for Analysis and Research teams. Maintain records for budgeting and cost. M.B. KAHN CONSTRUCTION COMPANY, INC., Columbia, SC 01/2003 to 11/2008 Executive Assistant, Cullum Division

Provide administrative support to Executive Vice President, Vice President of Business Development, Estimators, Project Managers and indirect support to other construction management team members. Assist with marketing proposals, Owner/Architect agreements and contracts. Review subcontractor agreements and insurance information for accuracy. Coordinate meetings with potential and existing clients. Log, distribute and track shop drawings and project submittals. Assist with change orders, payment applications and project closeout.

BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA 10/2000 to 01/2001 Enrollment Analyst, Medicare

Reviewed Medicare provider information and resolved any provider problems that would hinder processing of provider application. Investigated and provided resolution to provider inquires. Assisted providers in application process to adhere to Medicare regulations. Investigated and reported trends of discrepancies with provider information. Reviewed and analyzed data from monthly reports. 2

BETTYE Y. MORRIS Page 2

RELATED PROFESSIONAL EXPERIENCE

AMERIHEALTH, Valley Forge, PA 02/1999 to 08/1999

Member Services Representative

Handled high volume of calls regarding enrollment, claims inquiries and complaints. Maintained customer focused professionalism while handling irate callers. Comprehensive knowledge of the claim and adjustment process. Verified eligibility of benefits to brokers, providers and benefit administrators. Assisted new representatives to maintain service standards and provided technical support. BLUE CROSS AND BLUE SHIELD OF OKLAHOMA 01/1998 to 07/1998 Claims Analyst, Federal Employee Program

Investigated payments and benefit determination for all lines of business. Resolved and documented any problems found during investigation. Processed and adjusted claims in an accurate and timely manner. Tested new procedures to enhance processing time.

INDEPENDENCE BLUE CROSS, Philadelphia, PA 11/1995 to 08/1997 Team Leader, Health & Welfare/500 Plus Group

Trained and monitored new representatives in maintaining customer service standards. Served as a liaison between group and internal departments to resolve claims, marketing and enrollment issues. Accountable for daily operational performance of team members. Identified training needs and resolved conflicts among representatives. Motivated team and held weekly meetings to keep team abreast of any new policies. Maintained accurate records of claims, provided reports to management of trends, problems and resolutions. Group Representative, Local Group Association 10/1993 to 11/1995 Assisted group leaders with claims resolution and handled difficult and sensitive situations with members. Handled high volume of calls regarding eligibility and benefits to group leaders and members. Assisted with training of new representative.

Claims Examiner, Individual Accounts 09/1991 to 10/1993 Investigated eligibility and verify claim charges. Ensured proper payment of claims for all lines of business. Responsible for prompt response to correspondence regarding claims or benefit issues. SUMMARY OF QUALIFICATIONS AND SKILLS

Able to work with little or no supervision

Excellent organizational skills

Proficient in Windows, MS Word, MS Excel and MS PowerPoint

Expert in identifying and resolving problems

Able to handle multiple tasks and projects simultaneously

Excellent communication skills, both written and verbal

Versatile in speaking to small and large groups

Comfortable in relaying technical knowledge in layman terms to others



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