Michael A. Davis

** ******** **., ***. **-**, Yonkers, NY 10701

518-***-**** - Mobile

ac4y57@r.postjobfree.com

Seeking a responsible position that requires excellent administrative and Customer Service skills, preferably in a healthcare environment.

SKILLS: Type 75+ wpm; MS Office Suite; Insurance Claim Systems (GuideWire, NextGen, & Phoenix), Customer Service; IDX Claims Payment System, Office Coordinator; Human Relations; Communications; Ability to Multi task; Highly organized, efficient, motivated and reliable.

EXPERIENCE:

MERCURY INSURANCE GROUP CUSTOMER SERVICE REPRESENTATIVE II

Responsible for data entry in claims database for all “First Notice of Loss” claims calls submitted by insureds. Inbound and outbound calls. Demonstrated accurate data entry and ability to communicate with customers as a CSR-1. Promoted to CSR-2 and demonstrated ability to process billing calls as a billing specialist. Responsible for explaining current billing procedures to customers, providing current amounts due, and taking payments via credit and debit cards as well as via check payment system. Received specified training for dealing with irate customers and various payment systems.

COVENTRY HEALTHCARE SERVICE OPERATIONS SPECIALIST

Responsible for all aspects of customer service including, but not limited to, enrollment and eligibility records, entering enrollees into IDX claim payment system, reviewing and verification of provider’s licensing and credentials, responding to customer inquiries, and resolving customer concerns within a team environment. Process and maintain enrollment and eligibility records by ensuring enrollment applications are complete, enter demographic information into the enrollment database, and resolving basic to complex enrollment system rejections.

- Ensure enrollees are accurately entered into IDX claim payment system.

- Ensure all providers have proper credentials and licensing.

- Process basic and complex group or individual enrollments, and/or adjustments.

- Authorizations, payments, denials, enrollment, and eligibility.

COUNTY OF SACRAMENTO, DBHS SENIOR OFFICE ASSISTANT

In Home Support Services - Public Authority

Responsible for the registration of care providers in Sacramento County. Process involved data entry into county database and facilitating background checks and orientation classes on all rules and regulations of In Home Support Services. Additionally, maintained county statistics in state CMIPS system.

Children’s Mental Health Division

Duties included maintenance of CCMS file room and CAPS Clinic file room, medical billing processing and maintaining patient charts. Scheduled appointments and clinic preparation. Data entry of billing information for all psychiatric and psychological medical and case management services rendered by DBHS physicians and psychologists. Admit and discharge clients to and from various clinics as defined by Sacramento County and care coordination with ACCESS unit and contracted agencies. File management including daily distribution of client charts to various clinicians as well as updating and maintaining documentation in charts according to county and state regulations.

References Furnished Upon Request