Customer Service Medical
Resume:
Deann Turner
Email: aboyjc@r.postjobfree.com
Address: **** **** ** **
City: Cedar Rapids
State: IA
Zip: 52401
Country: USA
Phone: 319-***-****
Skill Level: Experienced
Salary Range: 40
Primary Skills/Experience:
See Resume
Educational Background:
See Resume
Job History / Details:
CAREER SUMMARY
A creative, efficient, diligent problem solver; motivated to exceed position expectations. Dependable, responsible, and resourceful. Areas of skill and experience include:
a Customer Service: 17+ years providing excellent service to customers and team members.
a Personable: Positive attitude; clear communicator, adapt well to change, turns work around fast.
a Healthcare Knowledge: Medical Terminology, WebMD research for FDA approval, HIPAA privacy.
a Computers: Windows XP, Microsoft Office - Word, Excel, PowerPoint, NetworkX, TriZetto,Principal Claims System
PROFESSIONAL EXPERIENCE
PRINCIPAL FINANCIAL GROUP Hiawatha, Iowa 1993 - 2012
A leading global financial company offering businesses, individuals and institutions financial products including retirement, insurance, and investment services.
Senior Claims Examiner 1997 - 2012
a Evaluate group contracts and plan provisions to ensure accurate benefit payment.
a Examine claim applications for completeness and accuracy. Interview medical specialists and consult policy to verify the information reported on the claim.
a Authorize appropriate payment, deny claim, or refer to medical personnel for further review.
a Assist managers, claims specialists, supervisors, and medical departments with specific inquiries from members, providers and employer Human Resource Departments.
a Respond to outstanding issues with members, providers and HR/employee benefits staff.
a Prepare reports to be submitted to companyas processing department.
a Maintain 99.5% procedural and dollar quality for claim payments.
a Excellent oral and written communications skills.
a Excellent organizational skills in efficiently handling of all confidential clients and providers.
Claims Examiner 1993 - 1997
a Explained claims determination and benefits to customers via calls, letters, and emails.
a Researched pending claims to determine accuracy and completeness.
a Contacted claimants, doctors, medical specialists and employers to acquire additional necessary information.
a Determined accurate claim payment and documented the claim file for all communications and actions taken.
a Reported overpayments, underpayments, and other irregularities such as errors in coordinating benefits between multiple carriers.
WELAND CLINICAL LABORATORIES Cedar Rapids, Iowa
Certified Medical Assistant, Phlebotomist 1989 a 1993 Full-time
1993 -1996 Part-time
a Efficiently performed administrative duties; greeting patients, answering phones, scheduling appointments, maintaining medical records, and patient processing which allowed doctor
and nursing staff to focus on the health concerns of their patients.
a Demonstrated proficiency in taking patient medical history and vital signs as well as blood work,
urinalysis and various diagnostic procedures.
a Ensured cleanliness, sanitation and maintenance of all facilities, exam room and equipment.
a Reacted calmly and effectively in emergency situations, with added personal care to swiftly put patients at ease.
Education
Certified Medical Assistant Kirkwood Community College 1986
Professional Development
Healthcare Fraud Prevention, HIPAA Privacy Regulation, ERISA Guidelines, Managed Care Regulation, Healthcare Reform Laws, Code of Business Conduct and Ethics
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