Customer Service Quality Assurance

Nerissa C. Chitolie

********@*****.***

***** ******* *** ****, *******, TX 77429 713-***-****

OBJECTIVES

Pursuing a position in the area of insurance health Claims

billing/coding/processing, adjuster/ quality assurance, patient

accounts/registration, administration/clerical, and customer

service, which will utilize my acquired skills and experience.

EDUCATION AND TRAINING

Colorado Technical University, Online - Colorado Springs, CO

A.S., - Medical Coding and Billing (currently enrolled)

National Education Center- Silver Spring, MD

Medical Assistant - 1984-1985

Cambridge University- Cambridge, England

General certificate of Education

CAREER SKILLS/KNOWLEDGE

Offering an extensive background in claims analysis, medical

billing and coding, with emphasis in the area of medical,

dental, hospital, and short term disability.

. Processing insurance health claims/employee health claims

in accordance with policy guidelines, to include

Coordination of Benefits when applicable.

. Proficient in Medical Terminology, CPT, and ICD-nine

coding.

. Quality Assurance- Reviewing and adjusting insurance claims

for payment and processing accuracy.

. Customer Service - Providing policy/claim information to

providers and members, handling adjustments for appeals and

grievances.

. Auditing high dollar claims.

. Responsible for training new employees in accordance with

company/policy guidelines.

. Performance coaching / Team building

. Volunteerism

. Organization / Prioritization / Strong communication skills

EARLIER EXPERIENCE

2005 - 2011

. Coordinated Homeschooling curriculum and activities for

Junior High and High school children. Drafted course

curriculum, graded tests, evaluated results, reviewed

research projects and planned field trips.

. Worked with local church as a VBS volunteer; responsible

for registration and preparation of work material for daily

student activities.

. Enrolled at Colorado Technical University; pursuing an

Associate of Science degree in Medical Billing and Coding.

2001 - 2005 United Behavioral Health - Houston, TX

. Claims Adjuster

2000 - 2001 Medical Center OB GYN - Houston, TX

. Medical Billing / Coding

. Customer Service / Collections

1999 - 2000 Amerihealth - Houston, TX

. Senior Claims Examiner

1996 - 1999 Nylcare - Houston, TX

. Claims Examiner

1991 - 1996 American Psych Management - Arlington, VA

. Claims Analyst/Trainer

1989 - 1991 New York Life Insurance - Washington, DC

. Claims Examiner /Customer Service

1987 - 1989 Physicians Care - Arlington, VA

. Claims Examiner/Customer Service

1984 - 1987 Mutual of Omaha - Washington, DC

. Claims Examiner

TECHNICAL SUMMARY

Microsoft Word, Excel, PowerPoint, 10-key Calculator

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