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Customer Service High School

Location:
Effingham, SC, 29541
Posted:
October 22, 2010

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Resume:

DEMETRIA WILLIAMSON

**** ********* ** *********, ** C: 843-***-****

abilu2@r.postjobfree.com

PROFESSIONAL OBJECTIVE

To gain a position that will provide me the opportunity to make a strong contribution to the overall

growth of a company.

EDUCATION

HIGH SCHOOL DIPLOMA JUNE 1992

West Florence High School

Related Courses:

CPT-4

ICD-9

Medical Terminology

Pricing based on DRG

Professional claims (HCFA 1500, CMS

1500)

Institutional claims (UB-92)

Computer Skills:

Proficient in Microsoft Word, Excel, Project, Access, PowerPoint,

Experience

Customer Service Representative III for Blue Cross Blue Shield of Florence (TRICARE)

- Government subcontractor responsible for processing medical claims for active/retiree

military members in the South region.

(January 1997 - January 2010) Florence SC

Responsibilities included:

• Provided written/telephone correspondence to the members/ providers and physicians

• Medical claim review, processing and adjudication

• Researched and implemented the appropriate ICD-9 and CPT-4 codes for payment

determination

• Maintained a quality rating score of 100% based on accuracy and timeliness

• Continuously attended training on Tricare policies and procedures regarding the

healthcare field

• Coded/Keyed claims in the system and work thru to complete claim processing

• Researched new/existing provider(hospitals, physician offices, labs and clinics)

credentials and applications to assign tax identification numbers

Leadership Experience

Served as Team lead ensuring that team was current on all training and revisions received on a

constant basis, often responsible for special/bulk projects that required immediate attention.

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DEMETRIA WILLIAMSON

2322 MCELEVEEN LN Effingham, SC C: 843-***-****

abilu2@r.postjobfree.com

Page 2 of 2



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