Customer Service Human Resources

Kimberly McCloud

**** ******* *** **********, **** 45236

513-***-**** / ******@*****.***

Aspirations

I'm seeking a long term career where I feel my background and education

make me an exceptional candidate. I'm interested in this position for its

educational and growth opportunities.

SKILLS PROFILE

Highly effective learner who adapts easily to change.

PHR Certified

Extensive knowledge of CPT, ICD9, HCPC, and experienced with UB92 and

1500 codes.

Several years of experience working with Medicare and Medicaid.

Positive, hard working and highly effective learner.

Excellent attention to detail, and exceptional critical thinker.

Over 9 years of Customer Service experience.

EMPLOYMENT HISTORY

Human Resources Manager, Olympia Orthopedic 2009-Current

Associates P.L.L.C

Olympia, Washington

Initiated and developed new policy and

procedures.

Controlled the areas of payroll, personnel,

employee relations, instruction, and

confirmatory action.

Update current policy and procedures to federal

and state standards.

Responsible for creating and developing new

employee training system which contained all

compliance related training courses.

Effectively and efficiently did all Payroll

duties, including timecard management, benefits,

and worker's comp, FMLA, and OSHA obligations.

Facilitated and trained all 160 employees on

compliance related materials. As well educated

the employees on current Open Enrollment and

benefit procedures.

Claims Research Analyst, Humana Inc.

Cincinnati, Ohio

2007-2009

Investigate member and providers concerns with complex claims/benefit

issues, research and analyze their concerns and complete any necessary

changes in a timely manner.

Facilitated new employees with job details, and organizational training.

Build trust with member by understanding their needs and assisting them

with their concerns.

Properly document information into member's file for future reference.

Provide follow up and recommendation for best practices. Recognize

learning opportunities and educate other team member's on trends.

Addition training and accomplishments include; I was trained in the

Texas/Arizona markets within two months of being hired (typically done

after 1 year of service), was promoted to the Designated Call Center six

months after initial hire date, and received second promotion to the

Claims Research Analyst position after mastering the Designated Center in

eight months.

Clinical Pharmacy Representative, HME Services, 2002-2007

Inc.

Cincinnati, Ohio

Enter/Pick up orders from system on daily basis for patients' mail orders

and assist with filling.

Communicate with medical personnel, pharmacist, nurses, and doctors in

regards to pharmaceutical claims and billing.

Prepared invoices for billing and payment.

Recorded dosages and strengths in member's record/file.

Maintained long term/monthly maintenance orders for pharmacist.

Educated patients on accuracy of prescription in order to maintain

compliance and usage with great communication skills.

EDUCATION

Diploma 2001

Norwood High School, Cincinnati, Ohio

Associates Degree (Human Resources)

Penn Foster, Scranton, PA 2008

PHR Certification

2010

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