Customer Service Medical

PHYLLIS O. MCCALLUM

**** ******* ****** **********, **, 27401 336-***-**** aca5or@r.postjobfree.com

SUMMARY

Enthusiastic, focused individual with excellent eye for detail. My key competencies include Accounts Payable

and Receivable, extensive experience in retail as a merchandiser, customer service specialist, six years of health

insurance claims processing and addressing medical insurance appeals - seeking a position where I can apply my

skills, experience and commitment to job excellence.

KEY COMPETENCIES AND SKILLS

Customer Service HIPPA Compliancy Medical Claims processing

Microsoft Word Confidentiality/Professionalism Accounting Concepts

Microsoft Excel Microsoft Access Detail-oriented

Operate 10-key calculator Medical Terminology Review vendor statements

Quality customer service skills Excellent communication skills Strong organizational skills

WORK EXPERIENCE

Legal Caregiver, Greensboro, NC 2010 – Present

Caregiver Associate

• Provide transportation for physician’s appointments and errands

• Communicate with healthcare providers regarding health issues, treatment and insurance

• Contact contractors, third parties and facilitate house maintenance and repair

• As Power of Attorney, responsible for management of finances

United Healthcare, Greensboro, NC 2004 - 2010

Issues Resolution Unit Associate

• Responded to various information request from provider and patients

• Documented key information points in tracking system

• Assigned documents, cases and or appeals to appropriate department to be addressed or to grievance

investigators

• Thorough documentation and preparation of case for appropriate review and decision making

Transaction/Claims Processor

• Analyzed claims to ensure accurate claims adjudication

• Processed claims in accordance with EOC, benefit schedule, plan and provider contract

• Problem identification and reporting to supervisor or management

• Coordination of benefits based on sop, specific plan provisions and state regulations

Banknote Corporation of America, Browns Summit, NC 1997- 2003

Accountability Associate

• Collected and entered data in spreadsheet to calculate accuracy of job

• Researched origin of and reconciled discrepancies shown in spreadsheet

• Utilized database to record and help monitor waste of product

Guilford Technical Community College, Jamestown, NC 1997

General Office Assistant

• Typed letters, filed, retrieved information and received/processed various correspondence

• Entered student information in computer system

EDUCATION

Guilford Technical Community College, Jamestown, NC

• Associate’s Degree - Medical Office Technology 1997

Rutledge College, Greensboro, NC

• Associate’s Degree – Accounting 1983

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