Customer Service Data Entry

OBJECTIVE: To obtain a position that is looking for an ambitious, responsible, innovative, and career driven individual where I can utilize my acquired skills and experience towards continued growth and advancement.

HIGHLIGHTS OF QUALIFICATIONS:

Twenty years of experience with the Independence Blue Cross (IBC) Family of Companies. Meticulous and highly organized with a vast array of office management, problem solving, and customer service skills.

Obtain and maintain the necessary skills to access information from various systems in order to efficiently handle inquiries and submit claim filings

Self-starter, highly motivated, problem solver with the ability to work independently in a fast pace environment

Customer-oriented professional with strong interpersonal and communication skills.

Demonstrated ability to manage and prioritize multiple tasks in a dynamic work environment.

Professional, dependable, team player.

Possesses an in-depth understanding of emerging technologies - quickly learns and masters new software/hardware systems. Working knowledge of Sliq, IBC mainframe, MHS, CIS, Planmate, MSIQ and INSINQ

Detailed Professional Experience

Independence Blue Cross Family of Companies October 2002 – June 2017

Team Service Representative (Customer Service)

Philadelphia, PA

Independence Blue Cross is a health insurer based in Philadelphia, Pennsylvania in the United States. IBC is the largest health insurer in the Philadelphia area, serving more than two million people in the region and seven million nationwide. Additional duties included:

Responsible for managing day to day operations of the issue in-take, management, and solution development for activities and tickets.

Track team activities and follow up on progress regularly.

Create a mechanism to track and report issues and risks and escalate as necessary to leadership.

Communicate regularly with leadership on outstanding business decisions, issues and risks and team progress.

Communicate known issues regularly to impacted business areas to mitigate member experience issues.

Responsible for developing proactive ways to identify issues by using various reporting and reconciliation processes in partnership with the reporting and analytics team.

Review and prioritize tickets and requests based on criticality, complexity and skill set required.

Manage open ticket/issue inventory and assign to team to analyze, fix and clean up

Act as liaison between the business areas and solution partners; e.g. BTS and other Corporate Shared Services teams to track and obtain status of fix and clean up related to CICS, Health Rules, and other databases and/or data sets used to run the business.

Establish and maintain meeting cadence and facilitate meetings to check status of set up, confirm timelines, resolve issues, etc.

Ensure applicable corrective action plans to issues are developed and implemented.

Responds to member calls about benefits and claim inquires with prompt, accurate and courteous responses.

Responds to provider calls about benefits, eligibility, and claim inquires.

Investigates documentation and resolve claim issues.

Actively demonstrates comprehensive understanding of IBC products, the competitive environment and the industry.

Documents summary of calls and maintain phone logs.

Independence Blue Cross Family of Companies May 1997 – September 2002

Senior Data Entry Operator

Philadelphia, PA

Independence Blue Cross is a health insurer based in Philadelphia, Pennsylvania in the United States. IBC is the largest health insurer in the Philadelphia area, serving more than two million people in the region and seven million nationwide. Additional duties included:

Promoted positive client relationships, education and analysis of client claims losses as well as analysis and resolution of current Stop Loss reimbursement issues.

Worked collaboratively with our internal and external customers

Processed AmeriHealth and Personal Choice medical claims.

Processed HCFA 1500/UB92 claims, PPO facility claims.

Researched claim issues.

Trained temporary employees to process claims.

Prepared source data for entry by compiling and organizing data; established priorities.

Entered data by operating data entry equipment; coded information; resolved problems.

Verified and balanced data, reviewed data; pulled and returned data to user for correction.

Completed data management by sorting, batched, and archived files.

Accomplished department and organization mission, completed related results as needed.

EDUCATION:

High School

John Bartram High School

Status- Graduated

Certificate- Diploma

References provided upon requests

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