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Customer Service Quality Assurance

Stone Mountain, Georgia, 30083, United States
April 23, 2012
Contact Info:

Tymia Leathers
**** **** **** ***** ***** Mountain, GA 30083 Phone: 678.***.**** E-mail:

To contribute to your organization utilizing my skills and knowledge efficiently and accurately perform bill processing.

Summary of Qualifications:
Offering over 12 years of excellent customer service and claims experience
Highly disciplined, organized and goal oriented
Uses analytical and communication skills to successfully carry out responsibilities.
Proactive leader and problem solver with strong research skills
Proficient in Microsoft Word, Excel, 10 Key Numeric, Data Entry, TYPE 50WPM/ 10,000+ KSPH
Working knowledge and use of CPT-4, ICD-9, HCPCS, HCFA, UB-92 and Medical Terminology

Work History:
Bill Specialist I Crawford & Company (Broadspire), Atlanta, GA 2005-2010
Accessed and verified claim numbers in multiple claim systems.
Reviewed medical literature to resolve problems and approve claims for payment.
Reviewed and interpreted procedure codes (CPT-4), ICD-9 diagnosis codes and nature of injury to determine medical causality
Ensured activities were performed according to established schedules, client requirements, and corporate standards
Utilized internal forms and notes to communicate findings to Branch Office and providers
Accessed bill classification information to change receipt date, entered information required to complete bill adjudication.
Performed verification and research of workers compensation bills.
Assigned resolution codes to complete bill processing
Bill Provider Analyst Crawford and Company, Atlanta, GA 1998-2005
Researched claim information and authorized pending bills for payment
Assisted in mail processing, data entry, editing bill entry, adjustments, and quality assurance
Met required quality/production standards while maintaining turn around on assigned states
Determined medical casual relation, routing bills
Proof Operator South Trust Bank, Atlanta, GA 1997-1998
Operated a proof machine; sorted and proofed deposits, debits/credits,
Encoded and balanced customers account transaction
Maintained quality and quantity standards to promote effective customer service
Balanced deposits and performed a variety of clerical functions relating to check processing
Reconciled errors and made appropriate adjustments and corrections when necessary

Stone Mountain High School, Stone Mountain, GA
College Preparatory Diploma