Customer Service Data Entry

Lori Tiburcio

*** ********* ****** ********, ** *2910 401-***-**** *********@***.***

Data Entry Specialist / Claims Adjuster

Detail oriented and client focused

with exemplary customer service, negotiation, crisis communication, and analytical skills.

Adecco Temp Agency

NEIGHBORHOOD HEALTH PLAN OF RI - March 15, 2010 to October 9, 2010

Presently working a long term Temporary position at Neighborhood Health, entering Medical information from Hicfaa claims forms into

the Diamond computer system.

Knowledge of Hicfaa or UB92 forms Typing letters and mailing them to various Hospitals to make corrections to claims that are unable

to be processed.

Assisting QA with any duties required

Experienced within insurance field coupled with expertise providing seamless insurance claim support and customer service to

clients. History of representing employers with a highly professional image through personal client contact and proactive

phone communication. Reputation for avoiding conflict by demonstrating compassion and empathy. Background of carefully

investigating situations and providing satisfactory solutions. Proficient in MS office, Excel, Outlook, and subro source.

Worked on dual monitor, paperless computer system.

Professional Excellence

First Comp Insurance

Claims Medical Only Examiner

Customer Service Representative

Claims Unit Coordinator Assistant

Warwick, RI: Served as first point contact for insured members within 24 hours of claims handling. Explained insurance benefits, Conduct prompt and

thorough investigations, evaluate facts, interpret laws and regulations, and render determinations, including compensability and medical determinations,

contact medical providers to provide billing information and request medical bills, paid medical bills through Genex and Rising billing review system,

followed protocol reserving, evaluated claims, accurately recorded statements and typed transcriptions. In depth knowledge of the basic insurance policies,

procedures and strategies. Continuously analyze case facts and monitor activities in order to identify possible fraud and/or abuse, and/or third party

liability throughout the course of the claim.

Leviton Manufacturing Company

Receiving Department/Customer Service

Maintenance Department Clerk

Data Entry (Data Processing Department)

Twenty One years of related experience, familiar with a variety of software including Microsoft Office, Excel, Word, Excel, IBM, Oracle, Nixdorf,

Mapics, Passport and Maverick, utilizing Dell dual monitor Computer Systems. Proficient in data entry of invoices, packing slips, purchase orders, and

entering inventory and stock tickets. Data entry speed 170**-***** numeric strokes per hour. Receiving UPS and Fed Ex packages, troubleshooting

and tracking information for payment and deliveries to departments and stock locations. Filing, faxing, time cards, and vouchers.

Education and Licensure

High School Diploma, RI Licensed Insurance Worker’s Compensation Adjuster,

Insurance Essentials Certificate, RI Licensed Cosmetologist, Graphic Art Diploma

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