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Customer Service Insurance

Location:
Grand Rapids, MI
Posted:
July 25, 2017

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Resume:

CHRISTINA PAGE ** Dogwood Lane, Charleston, WV ***12

ac1g8p@r.postjobfree.com 304-***-****

O BJECTIVE

Dedicated, hard working, people oriented person with over 12 years of customer service experience. QUALIFICATIONS/ SKILLS

● Proficient in Microsoft Windows and Outlook 2016

● Strong work ethic, service oriented attitude, ownership attitude, adaptability,confident, strong oral and written communications skills

● Reliable and detail-oriented, great organizational skills PROFESSIONAL EXPERIENCE

CAPITAL AREA SERVICES CO INC – C harelston, WV

S enior Customer Service Advisor/ Carefirst BCBS (August 2014-Present) Answer incoming calls from members and providers to provide plan benefits for copayments,deductibles and coinsurance.

Verify and update eligibility for members and dependents. Provide claim status for claims submitted by members and providers. Research claims for errors to make adjustments and contact providers to have claims resubmitted for errors if necessary. Use knowledge of products and the contractual provisions that govern administration to provide customer service and education, to interpret language to the customer for the purpose of providing benefit utilization and limitations, to determine the need for managed care initiatives, and to administer all types of services to customers within business segment through telephonic inquires, written and /or electronic inquiries and claims adjustments, if applicable. Appropriately document all client interactions according to established departmental procedures. Examine adjudicated claims to identify key elements and processing requirements based on diagnosis, procedure, provider, medical policy, contracts and policy procedures. Research deductibles, maximums, co-payments and coinsurance for resolving inquires, facilitating adjustments, initiating extra contractual and reporting of any systems processing errors, overpayments, and underpayments. Develop and apply the ability to analyze customer contracts and needs involving current product mix, risk assessment, and revenue impact. Developing service techniques and technical competence for the purpose of maximizing customer retention, satisfaction, and potential financial savings. Provide effective support in coaching, training and the motivation of new team members. U NITED TALENT – Charleston, WV

M edical Billing Specialist/ Professional Healthcare Billing Services (April 2014-July 2014) Assemble patient records

Enter patient demographics in HEALTHPAK system.

Continued...

Obtain insurance deductibles from GATEWAY and NAVINET systems for billing. Process payments made from patients and insurance companies. Copying patient medical records for insurance purposes. PAGE INSPECTIONS LLC Northern Virginia

Home Insurance Inspector (August 2010 – December 2013) Licensed business owner contracted for private home insurance services to provide accurate and detailed property information. Manage scheduling prioritization and routing in order to efficiently meet short deadlines.

Documenting inspections written, photographic, and diagrams Interface with individual homeowners in order to gather required information and any all documentation to support property’ condition and records. R IVERVIEW BAPTIST DAY SCHOOL Woodbridge, VA

P re-School Teacher (July 2009-May 2010)

Taught pre-school class of 10

Creatively tailored curriculum to meet the needs of a diverse group of students Developed lesson plans and class schedules

VIRGINIA HOSPITAL CENTER – A r lington, VA

M edical Records Technician/Release Specialist (July 2007-July 2009) Process medical records in compliance with state and federal regulations Compile and maintain patient’s medical records to document condition and treatment

Provide data for research or cost control and care improvement efforts Release information to persons and agencies according to regulations Balance and process deposits, and payments for accounts that are copied required further health treatment or legal matters.

GYMBOREE CORP. – Springfield, VA

Assistant Manager ( January 2005 –October 2006)

Managed the day-to-day operations and conduct of business. Supervised store employees in all areas of the daily performance of their duties. Implemented plans to maximize sales, made weekly and monthly deposits. Exceeded goals and objectives in all key performance areas Recruited and hired new employees, ensured compliance to visual presentation and operational standards in store, maintained site standards, including but not limited to cleaning, stocking, and pricing of merchandise. Burke & Herbert Bank & Trust Co. – A lexandria, VA Trust Operations Administrative Assistant ( March 2003 – October 2004) Responsible for ordering and maintaining office supplies for entire Trust Department

Monitored daily and periodic cash balances in Trust Accounts, oversaw cash flow within operations area including the overall balancing of disbursements, receipts, wire transfers, check runs, and bank accounts.

Processed contributions and withdrawals (checks, ACH’s and wires) Managed and oversaw the bank’s M&I System to support the administration of Trust and Investment Accounts.

Balanced and reconciled trust accounts on a daily basis. Printed, read, and filed all Trust Reports daily while ensuring all reports and documents were prepared properly, oversaw all wire transfers of funds for reconciling accounts, monitored large balances and overdrafts for all Trust Accounts. Handled incoming calls and responded to clients requests in the absence of management, handled all correspondence and routine matters without direct supervision.

EDUCATIONAL BACKGROUND

F airfax County VA/ Medical Assistant Student – 2007 to 2008 Northern Virginia Community College – 1996 to 1997



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