Customer Service High School

Dawn Crothers

Email: ********@***************.***

Address:

City: Stafford

State: VA

Zip: 22556

Country: USA

Phone: 402-***-****

Skill Level: Any

Salary Range:

Primary Skills/Experience:

Exceptional Customer Service Representative with a varied background of experience in: Hospital, Surgery,HME and Provider Billing Auditing & Paying Hospital, Surgery, HME and Provider claims Supplemental Health Insurance Product Claim knowledge and filing Property and Casualty Sales, Underwriting, Accounts Receivable I am seeking a challenging career with growth potential.

Educational Background:

High School Dipolma from North Stafford High School, Stafford VA 1/2001 to 6/1996 (Standard Diploma)

High School Dipolma from Germanna Community College, Stafford VA 1/2001 to 12/2012

Job History / Details:

Summary

Exceptional Customer Service Representative with a varied background of experience in:

Hospital, Surgery,HME and Provider Billing

Auditing & Paying Hospital, Surgery, HME and Provider claims

Supplemental Health Insurance Product Claim knowledge and filing

Property and Casualty Sales, Underwriting, Accounts Receivable

I am seeking a challenging career with growth potential.

Highlights

Strong Customer Service and Sales Background

Timely and Efficient

Dependable and Organized

Skilled at Microsoft Office, Excel and Outlook

Worked with Programs such as Passport, GECE, Medipac, HPF, Xactimed, Trac, EPIC and Pulse Pro

ACD Phone experience

Accounting and Cash posting experience

Experienced in customer objection handling and complaints

Understanding of Medical Terminology, CPT codes and Diagnosis codes

Skilled in Underwriting and Risk management

Adjusting policies, renewals and handling cancellations

Running Credit, Clue and MVR reports

Processing credit card and check payments

10 key machine, fax and copier experience

Experience

September 2011 to Current

Inova Health Systems Falls Church, VA

Customer Service Representative IV

Review of claims from multiple payer types (Commerical, Managed Care, Blue Cross,Medicare, Medicaid, etc.)

Assure all claims meet clearinghouse and/or payer processing criteria

Assure appropriate follow-up on work lists

All work meets departmental productivity and quality review standards

Provided team management with issues regarding claims follow-up process

Provide team supervisor or manager with issues and potential resolutions regarding problems with the claims process

Provide support, education, and guidance to team

Perform duties, as assigned, in absence of supervisor or manager

Assure appropriate and timely documentation of all account activity

Correspondence handled appropriately

ACD Phones

EPIC Super User

June 2009 to July 2011

Blue Cross & Blue Shield of Nebraska Omaha, NE

Health Insurance Auditor - Claims Processor

Experienced in Health Care Reform claims

Handled special groups that required specific instructions to pay out claims

Experienced in Medicare, Medicaid and 3rd party payors

Handled group submissions for Health Fair Claims

Processed Manuel Allotments & Split Claims

Worked with performance groups that require strict turn around time and excellent quality

Awards for Creative Thinker and Teamwork

Understanding of Medical Terminology, CPT and Diagnosis codes

Involved with running auctions for the Susan G. Komen Race for the Cure, to raise money on behalf of Blue Cross & Blue Shield

Participated also in the following company sponsored charity events: Susan G Komen Race for the Cure, Special Olympics and BoysTown National Research Hospital

April 2007 to April 2008

AFLAC Omaha, NE

Customer Service Representive I - Claims

Customer Service - handling benefits & claim processing

Received training in Microsoft Word, Excel,Outlook and Medical Terminalogy

ACD phone experience

Customer retention and resolution of claims for the following supplemental products to include: Disability, Vision, Medicare supplement, Accident, Hospital indemnity, Long term care, Cancer, Personal sickness

Ability to review medical records for possible benefits

Awards received for completion of Customer Service Specialist I, teamwork and having a postive attitude

March 2003 to January 2004

Department of Defense Mountain Home AFB, ID

Child Care Assistant

On call associate with excellent dependability and availability

Responsible for care of children from ages 0-5 years of age

Assisted in lesson plans and time management

Received a perfect review at my one year mark with employer

February 1994 to September 2001

GEICO Fredericksburg, VA

Sales Agent, Underwriter and Accounts Receivable Technician

Sales experience in Homeowner, Auto, Boat, Jet Ski, Mobile Home, Valuable Items, and Dwelling Fire policies

ACD Phone Experience Objection and Complaint Handling

Underwriting and risk management

Improving customer retention

Adjusting policies, renewing policies and handling cancellations

Running Credit, Clue and MVR reports

Processing credit card and check payments

10 key machine, fax and copier experience

Excellent typing skills and experience in Microsoft Word and Excel

Education

1996 North Stafford High School Stafford, VA

High School Diploma

Germanna Community College Fredericksburg, VA

Currently enrolled part-time with Germanna Community College

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