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Customer Service Medical

Location:
Clearwater, FL, 33763
Posted:
September 07, 2010

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Resume:

RAYMOND F. GUSTAVSON III

727-***-****

abjxix@r.postjobfree.com

CUSTOMER & TECHNICAL SUPPORT PROFESSIONAL

Accurate ~ Productive ~ Decision Maker ~ Problem Solver ~ Leader

SUMMARY

Offering a quick learning, experienced, professional, and dependable leader

who possesses excellent communication skills, is well organized, has great

attention to detail, and has learned a variety of software programs and

technical skills resulting from various work experiences and computer

education courses.

PROFESSIONAL ACHIEVEMENTS

o Opened/resolved over 5,000+ financial/technical requests/incidents in

Unicenter CA Service desk & CRM.

o Wrote various types of SITE specific edits that were implemented into

customer's databases.

o Wrote PowerPad instruction procedure, for the RIMS call documentation

system, explaining how to set up and configure the PowerPad buttons to

automatically populate data into the required fields.

o Participated in a refresh program by providing phone support to help

medical transcriptionists set up their DSL, cable, or dial up

connections and install/configure Cisco VPN on their new computers.

o Trained new employees on Remedy helpdesk software, HBO database,

proper documentation of calls,boH and insurance policy benefits and

procedures.

WORK CERTIFICATES & AWARDS

2003 Star Performer at Spheris in February for troubleshooting skills

and training employees on software.

2004 Wakely & Associates - Certificates for HIPAA training and anti-

fraud/privacy.

2005 Wakely & Associates - Certificate for Customer Service Telephone

Training utilizing LOMA.

2008 Wakely & Associates - Recognition for consistently adjudicating

200+ medical insurance claims daily.

2009 Caremedic - Certificates for HIPAA two part training course.

TECHNICAL COMPUTER SKILLS

Platforms: Windows 7/Vista/XP/2000/NT/ME/9X, Macintosh OS

Networking: TCP/IP, Ethernet, VPN, LAN, WI-FI,

McAfee/Norton/AVG/Avast/Comodo & Clamwin virus protection

utilities, Norton Internet Security, Windows Firewall

Tools: WebEx, PC Anywhere, and Dameware PC remote software, MS

Sharepoint, Unicenter CA Service Desk, Peoplesoft CRM, Vantive,

and Remedy help desk ticketing software, MS Office 2000, 2003, &

2007, Outlook 2003/2007, Outlook Express, Windows Live Messenger

Experience gained in past software and databases - RIMS, EMS, EQS, TWS,

CTS, Meditech, Medrite, Mestamed, Transnet, HBO, Precision 2000, MRP,

Hamus, Business Works, and Lotus Notes

GENERAL SKILLS

Typing 50 w.p.m., alpha/numeric 10,000 key punch strokes per hour, ten key

at 12,000 k.p.s.h, database maintenance, data entry, insurance customer

service, verification of benefits, claims adjudication, HCPCS, CPT, and ICD-

9 coding, HCFA, UB92, and UB04 claim forms, credit card verification,

retail collections, in home presentation of sales, invoicing, check

reconciliation, accounts payables/receivables, engineering transcription

PROFESSIONAL EXPERIENCE

CRITERION EXECUTIVE SEARCH, Tampa, FL

10/2009 - 5/2010

IT Consultant/Customer Service Support Analyst

1. Was bonded at Raymond James and worked a temporary contract there,

through Criterion Executive Search, providing application support for

the new Investor Access financial website implemented August 2009.

2. Took 40+ calls/day and created/resolved tickets using Vantive and

Unicenter CA Service Desk.

3. Helped client's enroll their financial accounts into Investor Access,

view cost basis information and present/future activity on account/s,

suppress statement, trade confirmation, and shareholder material,

download financial transactions into Quicken, assist with tax

information, unlock accounts, re-set passwords and security answers,

delete logins, configure client's Internet Explorer, Safari, and/or

Firefox browsers, delete cache, and resolve connectivity issues.

4. Helped financial advisors with mail packet linking, creating view only

logins, setting up online trading, and navigating through Financial

Advisor Investor Access.

5. Followed up on undeliverable/rejected statement and trade confirmation

emails to comply with internal audit.

CAREMEDIC SYSTEMS, St. Petersburg, FL

11/2008 - 7/2009

Support Delivery Representative

6. Provided application support via phone and emails for MedicareRT,

Claims Management, and Compliance Checking proprietary medical

software for over five-hundred medical facilities.

7. Created new incidents and then work orders in CMS CRM (Customer

Relationship Management) to send to development by attaching screen

shots, import/export files, and system master files, turned on and off

edits, and did technical writing for custom edit requests.

8. Researched rejected Medicare Part A claims via the Florida Shared

System claims processing software.

9. Mapped network drives, created new users, unlocked accounts/re-set

passwords on multiple servers, and remotely connected to user's

computers via WebEx to troubleshoot software issues.

10. Worked with production control to get missing 837 institutional and

professional medical interface files placed out on servers and to set

up auto interfacing of emails for facilities.

11. Diagnosed issues with 837I and 837P electronic medical claim files,

corrected improperly formatted data in the loops and segments in the

files, tested them by re-interfacing the files back in, and had

clients re-send them.

WAKELY AND ASSOCIATES, Largo, FL

11/2004 - 8/2008

Claims Adjudicator

12. After three months working temp to perm at Wakely, through Mentor 4

Staffing, I accepted permanent employment as a customer service

associate.

13. Answered/resolved 80+ Medicare supplemental insurance benefits/claim

status calls per day for Principal Life, American General, Union

Fidelity, Genworth Financial, Lincoln Heritage, and Royal Neighbors of

America.

14. Provided consistent and accurate call resolution within 14 day

compliance deadlines.

15. Requested check traces, wrote up adjustments, and worked

correspondence/contestability/subrogation files.

16. Was promoted to claims adjudicator and adjudicated and processed part

A & B electronic/paper Medicare supplemental and prescription claims

and did Medicare adjustments.

17. Also, provided emergency and overflow phone support for all insurances

aforementioned.

SPHERIS, ST. Petersburg, FL

10/2001 -

6/2004

Technical Support Desktop Technician

. Provided remote and on-site application phone support for TWS and CTS

transcription platforms.

. Used Remedy to open new incidents via email/phone and create work

orders to replace broken hardware.

. Remoted into employee's computers with PC Anywhere/Dameware and

configured DSL, cable, Cisco VPN, and dial up connections, removed

spyware/viruses, installed patches, improved PC efficiency, and re-

joined computers to the domain.

. Set up peripherals and troubleshooted issues at employee's work

stations.

. Used HBO database to validate patient demographics, decipher, edit,

and process transcription reports.

. Provided overflow phone support in the Customer Service department.

EDUCATION AND TRAINING

. Student at Columbia Southern University - Pursuing a Bachelor of

Science Degree in Information Technology.

. Presently studying for Network + certification.

. Earned CompTIA A+ (IT Technician) certification.

. St. Petersburg College, Clearwater campus, FL 1999-2004 - Internet

Orientation, PC Repair 1 & 2, Microcomputer Operating Systems,

Hardware Decisions, LAN, and other various courses.

. St. Petersburg College, St. Petersburg campus, 1991-1994 - Acquired

credits towards AA degree in Business Administration.

. Lakewood High School, St. Petersburg, FL - General Education High

School Diploma in 1990.



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