Customer Service Quality Assurance
Resume:
ESTELLA D. KENDALL
abuc9g@r.postjobfree.com
Phone 615-***-****
SUMMARY OF QUALIFICATIONS
Flexible availability; excellent typing skills; advanced software experience; extensive and strong background in
customer service, automotive/healthcare insurance and technology training; great personality; dedicated; hard-working
and well organized. Additionally, able to multi-task; fast learner and very detailed-oriented; dependable, on the floor
experience in peer training of new employees once individual(s) released from class room training and proficient with
computer operating systems-including: Windows and MAC. Skilled with comprehensive training in Medicare,
Medicaid and Commercial Health policies and payment procedures; proficient knowledge of auto insurance
polices/payment procedures (e.g.- MedPay,etc.) and coordination of benefits (COB); strong understanding of E-coding
and billing, additional medical terminology as well as UB, CMS/HCFA 1500 and Explanations of Benefits/Reviews
forms; training in individual patient case denials and appeals; strong working knowledge of Excel, PowerPoint, Word,
Outlook as well as law search engines (e.g. LexisNexis, etc.).
EDUCATION AND ACTIVITIES
Henry County High School, Paris, TN
Honors Diploma
University of Tennessee at Martin, Martin, TN: Graduated August 2008
Bachelors of Arts in English
Minor in Political Science: Paralegal Studies Concentration
Trained Paralegal
Collegiate National Honor Society
Grand Canyon University, Phoenix, AZ: January 2011- Current
Masters in Education (Secondary Training)- In Progress (Online)
PROFESSIONAL EXPERIENCE
COLLECTIONS AND DENIAL PATIENT ACCOUNT REPRESENTATIVE: RAI/RAI Outsource
Jul 12- May 13
Investigate unpaid and denied claims for patients
Thoroughly review patient’s health insurance benefits for available coverage(s
Review Explanation of Benefits/Payments/Review to further understand the processing of claim
Follow-up with health insurance carriers to determine how claim processed and payment procedure-if claim to be
paid
If claim denied, verify if denied correctly; if not prepare detailed appeal to be sent to insurance company for
review
Follow-up on appeals to get claims resolved
Handle claim disputes and resolution (between provider and insurance carrier)
Negotiate contracts terms between provider and insurance carrier and determine if payment rate is valid and, if not,
gather justifiable reason for underpayment
FIRST PARTY COLLECTIONS AND INVESTIGATIVE CLAIMS SPECIALIST: M.R.A
Sep 10- June 12
Investigate new patient cases
Determine if possible payment of claims available through patient's insurance carrier, or possible third party (if
involved and at fault)
Identify cases for denial and close out of company system
Review medical forms, including UB-04, HCFA 1500, Explanations of Benefits/Reviews, etc.
Follow-up with billed insurance carriers/attorneys for payments
Handle claim disputes and resolution
Determine source of unidentified payments
OFFICE ASSISTANT: MT State University Athletics Office
Aug 09- Aug 10
Answer multi-line phones
Responsible for several clerical tasks: making copies, taking messages, scheduling appointments, etc.
Formed and typed letters, memos, etc.
Delivered packages for and to inner and outer office personnel
Attended out of office events for working purposes: ticket and pass check-in, etc.
CALL CENTER ASSOCIATE/ HEALTHCARE CUSTOMER SERVICE REP.: AMTEMPS
Nov 08- Nov 09
Responsible for daily call center tasks
Answered customer/vendor questions
Met daily shipment quota
Made request calls to stores on multi-lined phones
Worked successfully in team environment with minimal supervision
PARALEGAL INTERN and ASSISTANT: Washburn and Hutcherson Law Firm
Jan 08-May 08/ Jul 08- Aug 08
Responsible for daily paperwork
Filed retired accounts
Researched various cases for court reference, etc.
Handled communication between client and attorney before and after appointment through letters, emails and
phone calls
Notified attorneys of any approaching deadlines as well as making arrangements for upcoming appointments and
court appearances, etc.
Typed wills, deeds etc.
Drafted and reviewed contracts
OFFICE ASSISTANT/SUMMER DAYCARE COUNSELOR: Paris Recreation Center
June 04-June 07
Responsible for all activities and overall well-being of the children at the Recreation Center
Developed activity plans according to individualized interest based on each child
Managed the activity center and maintained a safe, secure and entertaining yet educational environment
Managed the Recreation Center Office in an effective and time efficient manner
Answered phones, typed letters, created flyers promoting Recreation Center activities
CUSTOMER SERVICE ASSOCIATE/CASHIER: Board of Public Utilities
June 03-Aug 03
Daily interaction with customers
Took payments in person and over the phone
Checked mail for mail in payments
Carried mail to post office
Processed credit card payments
Balanced cash drawer each day
CASHIER/CUSTOMER SERVICE ASSOCIATE: Odom’s Foodtown
Oct. 01-Aug 03
Advised customers on questions about possible purchases and inventory restock
Check customers out at cash register
Maintained accurate cash drawer paperwork
Balanced cash drawer
REFERENCES
Coni Barnette, A/R Collections Manager
Former Supervisor
Jessica Krekeler, Claims Specialist
Former Coworker
Lorri F. Neal, Quality Assurance Auditor
Former Trainer/Mentor
Contact this candidate