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Quality Customer

Location:
Franklin, TN
Posted:
December 04, 2018

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Resume:

Tameka N. Burns

**** **** **** ******

Franklin, TN 37064

615-***-****

ac7vdn@r.postjobfree.com

Career Profile:

More than seven years of progressive experience and responsibility with documented success in the areas of Insurance Administrations at various organizational levels. A hands-on professional with a proven record of success. An experienced team player, bringing enthusiasm and energy into group efforts. Demonstrated record of high performance standards, including attention to schedules, deadlines, budgets and quality work. Able to serve as an agent for others, and trusted to speak on their behalf to accomplish desired results. Can easily break a large project down into smaller pieces, prioritize goals, and work under short deadlines without sacrificing creativity. Demonstrated ability to work effectively with clients.

Accomplishments

Experienced with Microsoft Office applications; familiar with general office equipment including copiers, fax machines, and 10-key calculators.

Customer Orientation establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.

Able to work effectively with other employees, patients, customers and external parties.

Type 60 wpm.

Experienced in AS400, Meditech Systems, and FACS.

Certified National Healthcare Collector.

Cacs and Acss System

Microsoft Excel

Employment:

United Health Care 2017 – Current

Recovery/Collections Representative Work At Home

•Spend 95% of each day on the phone, taking inbound and / or outbound calls (Handle inbound calls from providers through a call queue and initiate outbound calls to providers to discuss and resolve outstanding over - payments)

•Perform overpaid claim research and supply explanations to the providers in both verbal and written format

•Build rapport with overpaid providers

•Escalate recovery efforts through leadership and Network as needed

•Maintain a quality work product and reviewing quality results as a learning opportunity

•Maintain call productivity, including the financial target

•Manage individual PTO and work schedule through IEX

•Perform other duties as assigned

Payment Resolution Services/ Insurance Collections 2016 to present

Contact Providers by telephone or in writing and requested payment to collect on insurance overpayments.

Followed up with customers on established payment plans.

Oversee and corresponded with difficult providers and insurance companies to follow-up on problems.

Provided input and recommended for additional training or policy and procedure changes that was required to enhance service and productivity.

Responsible negotiations and problem solving with customers who do not pay

Supports multiple work types by taking calls in multiple queues

Initiates customer solutions for finances

Gabriel 2015-2015

Customer Services:

•Member of the quality programs

•Member of the safety and ergonomics program

•Very efficient in Microsoft Excel, Word and Access

•Proficiently load part numbers to mainframe computer P390

Verizon Wireless: 2012-2015

Customer services Representative:

Responsible negotiations and problem solving with customers who do not pay

Initiates customer solutions for finances

Payment negotiations and follow-up on arrangements

Collections of delinquent customer accounts

Suspension prevention

Account prevention

Account rehabilitation

Retention Dialing for high level collections

Supports multiple work types by taking calls in multiple queues

Assist customers with financial issues regarding wireless accounts

Coure’s Construction /Drywall Company 2009-2012

Office Administrator:

Bookkeeping and other clerical jobs.

Make outgoing calls to business clients to ensure satisfaction, update changes or requests.

Book appointments for future construction jobs.

Conducted quality review of performance within specific units for consistency with policies, procedures and applicable regulatory guidelines.

Recorded and reported review findings as required by the functional area.

Provided data in order to develop reports based on the quality monitoring results.

Provided input and recommended for additional training or policy and procedure changes that was required to enhance service and productivity.

Assisted in monitoring audit reports, auditing database and analyzing, compiling trend reports every week

Community Health-Professional Account Services:

Medical Account Collections/Refund Auditor: 2004-2012

Contact delinquent account holders by telephone or in writing and requested payment to bring account current.

Followed up with customers on established payment plans.

Oversee and corresponded with difficult patients and third-party insurance companies to follow-up on problems.

Followed-up with attorneys regarding bankruptcy, long term accounts, and workman’s compensation accounts.

Verified property and employment status to better assist with collection of bad debt.

Answered questions and complaints for insurance companies, patients and other employees.

Conducted quality review of performance within specific units for consistency with policies, procedures and applicable regulatory guidelines.

Recorded and reported review findings as required by the functional area.

Provided data in order to develop reports based on the quality monitoring results.

Provided input and recommended for additional training or policy and procedure changes that was required to enhance service and productivity.

Assisted in monitoring audit reports, auditing database and analyzing, compiling trend reports every week or month.

Education:

Franklin High School Diploma 1992



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