Customer Service Sales
Resume:
MYRA J. MOORE
Florissant, MO 63033
*********@*********.***
A Highly skilled team leader with the ability to aggressively resolve
issues, multi-task and manage projects to completion. A proficient
researcher, analytical thinker with excellent written and oral
communications skills and the ability to work cross-functionally with
accuracy. Demonstrated initiative with experience to work under pressure
and meet tight deadlines with organization and prioritization.
SKILLS
Microsoft Office, Excel, Word, Windows, Oscar, ProComm, Vantive, Outlook,
Messaging, PowerPoint, Spartan, Compass, Order Writer, Siebel, AMISYS, SQL,
People Soft, Oracle, Ixos, Global Collect, GPN (web based)
AS-400 and Medical Terminology
BUSINESS EXPERIENCE
Thomson Reuters.
Order Management Specialist
Feb. 2006 - April 2009
. Supported sales and managed client base in the U.S. and Canada
according to contractual obligations and protocol of investment
banking.
. Siebel application used to communicate with sales to process orders on
the front end, query client's demographics and check install position,
verify client related documents such as contracts emails and
statements of work.
. Oversee deadlines to achieve business targets and client satisfaction
using CRM.
. Follow up maintained projects which involved installs of desk top
applications, data changes, servers, circuits or upgrades via use of
Siebel, Vantive and Order writer. Managed new or changes in client
contracts.
. Vantive application used to verify customer needs and requirements,
track install upgrades, liaise with third parties such as IBM, Savvis,
and BT Radianz to ensure proper time tables and protocol are met.
Order Writer used as a communication tool for Compass data base
Install orders for clients.
. Compass and ProComm data base used to add or deleted users, set up
logons and password, verify install positions, permission users to
give access to products ordered, to ensure compliance and to bill for
services. Assist in implementation of new products for clients.
. Escalate issues when appropriate and drive recovery efforts. Conduct
data analysis. Assist in implementation of new programs and escalate
all delays to internal departments where interaction is need
. Work with collections to credit or debit accounts based on client
queries in Oracle, Ixos or Oscar which pulls various reports based on
pricing, install position of all services generated in Compass data
base.
. Coordinate meetings internally and externally regarding client
needs. Participates in operations meetings.
Set up Conference calls to ensure coordination of End to end order
process. Create reports using excel to enable clients to view month
end trending in sales.
. Act as a mentor/coach to new hires and existing staff as required.
Metro Media Technology
Account Manager
May.2005 - Oct. 2005
. Managed accounts for sales and main contact person for Outdoor Media
vendors.
. Verified new installs or change in service orders and liaised with
shipping departments to verify on time delivery.
. Follow-up on orders to ensure graphics, dimensions and creative were
accurate to the vendor's specifications within AS-400 data base.
. Reviewed aging report and made outbound calls to collect from third
party payers per contractual agreements.
Advanced Business Fulfillment, Inc. - St. Louis, MO
Client Analyst
Feb. 2004 - Dec.2004
. Managed approximately 125-175 Third party administrators-and Managed
Care organizations.
. Design letters, forms or checks for clients.
Generated monthly reports and end of year reports.
. Distributed health-care specific claim information, such as
explanation of benefits and revenue checks.
. Analyzed and resolved computer data problems via MCDS system and
provided help desk support.
. Research issues via computer generated FTP zip files, used coffee cup
to access files.
. Troubleshoot and provide technical instructions by identifying,
troubleshooting, and recording client problems in SIMON projects.
. Obtains secondary data from identified zip files appropriately
catalogs and stores originals
into MCDS system to print for clients.
. Initiate manual claim pulls for revenue insufficiencies.
. Carry out other responsibilities and projects as assigned.
. Train new Clients on how access and use the website.
. Promote/Up-sell new ABF products or services.
. Maintain a 24 hour response time to clients questions or concerns.
. Uphold a 3-5 day response time regarding new business or changes.
Health link - St. Louis, MO
Customer Care Associate
Dec. 2002 - Feb. 2004
. Responsible for answering incoming calls from members or providers
regarding physician's medical decisions or third party claim
information.
. Place outbound calls to follow-up on provider or member inquiries per
HIPPA guide lines.
. Quote benefits, verifying insurance and medical authorizations,
explain the process of appeals to members and providers per the Anita
data base.
. Research problem claims, direct members or providers to correct third
party payers regarding claim payment and benefits per WMDS claims
reporting system.
. Maintain a minimum of 100 calls per day.
. Attend monthly meetings to improve payment strategies to increase
revenue.
St. Johns Mercy Business Office - St. Louis, MO (Part-Time)
Managed Care High Dollar Collector
May 2001 - March 2002
. Responsible for the daily operation of processing patients accounts in
accordance with Managed Care Contracts and institutional policies and
procedures.
. Review the validity of incoming data, correcting information as needed
and process the account for payment.
. Set up proactive conference calls with other managed care companies to
research problem accounts.
. Made out-bound calls to members to provide information regarding
payment programs set aside for delinquent accounts and to managed care
companies and third party insurance companies to collect revenue.
. Attended monthly meetings with providers to improve payment strategies
or to resolves payment issues.
. Analyzed and review reports for ATB and AR reporting.
Reliable Life Insurance Company - St. Louis, MO.
Claims Auditing Representative
March 2001 - Feb 2002
. Processed death claims regarding life insurance payments.
. Investigated and research death claims to ensure payments were sent to
correct beneficiary
. Made calls to customers to inform them of claim payments due to them
from deceased relatives.
. Worked closely with field agents to ensure client's had an
understanding of death claim policies and benefits.
. Processed and calculated claims checks in the system for distribution.
. Generated and tracked checks in the data base which were sent out to
the beneficiary.
. Mailed correspondence letter to the beneficiary regarding funds
received per the death benefit payment.
United Health Care - St. Louis, MO.
Provider services Representative
July 2000 - March- 2001
. Responsible for answering incoming calls from health care providers
requesting information regarding benefit, eligibility or claims
information via U-net.
. Researched billing and claims issues via HMO, PPO Medicare benefits
and Managed Care contractual agreements Via Oracle application and Q-
star, researching revenue codes such as 837,277 and 997.
. Provided high level of customer service and met established call
productivity (70 calls min per day).
Magellan Behavioral Health Care - St. Louis, MO
Provider Relations Contract Specialist
Jan 1998 - July 2000
. Initiate, generate and track provider Letters of Agreement, contracts
and amendments from initial draft to full execution in AS-400 data
base.
Communicate contract terms, payment structures, and reimbursement
rates to physician, hospital and ancillary providers.
. Created SQL queries to tract provider's demographic information and
liaise with legal and the implementations team for negotiations and
accurate documentation to ensure credentials are sufficient Per JACO
standards.
. Assist in analysis and coordination of amendments, reimbursement, and
language changes. Request information of billing codes, services
provided and other information needed to complete the contract profile
in As-400 and AMISYS system.
. Perform due diligence semi-annually.
. Work with the contract Manager to oversee and prioritize in-coming
contracts in AS-400data base.
. Maintain centralized repository of contracts, both electronic and hard-
copy
. Visit clients as needed to resolve claims issues.
. Manage other business initiatives as required.
Magellan Behavioral Health Care - St. Louis, MO
Lead Intake Service Representative
Dec. 1994 - Jan. 1998
Lead Intake Representative training and supervising a staff of 15
representatives in a call center environment
. Communicate various types of EAP programs and counselors available to
members.
. Interact with field officers and regional case managers.
. Initiated a minimum of 80 calls per day outbound calls for assessments
per Magellan's standards.
. Collect and document demographic information for triage to appropriate
counselor in AS-400 data base.
. Coordinate EAP referrals, and inpatient/outpatient treatment with
counselors for members health plan, provider and or vendors.
. Delegated daily task per upper management.
EDUCATION
Bachelor of Arts - Health Care Management, Linden wood University 2003.
Contact this candidate