Customer Service Medical

Jermaine A Byrd

*** ******** ****., *********, ** 30016

Home: 313-***-**** - *************@*****.***

Career Overview

Over nine years of professional experience in the disability management sector for global giant Ford Motor Company.

Consistently high performing in high target goal statements of work. Excellent written and verbal skills with attention for

detail. Extremely productive in high volume, high stress, environments. Proficient in the use of disability databases such

as ALICS, MDA, DCM I&II, and WGS 2.0. Highly Productive in the use of Outlook, Excel, and Power Point applications.

Skill Highlights

Extensive Workers' compensation knowledge Medical terminology ICD-9 & 10

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Extensive STD & LTD Knowledge Current Procedural Terminology (CPT)

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Employee training and development HIPAA & ERISA compliance

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Claims appeal procedures Typing 60 WPM

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Core Accomplishments

Customer Service:

● Negotiated company polices and procedures as a Union Representative for Teamsters Local 614 for 7

years.

● Received quarterly and annual incentives for consistently meeting statement of work standards.

● Received several Above and Beyond Awards from Benefit Representatives of Ford Motor Company.

● Lead testing and training for the implementation of ALICS database

Professional Experience

Disability Case Manager

January 2009 to June 2011

Unicare Life and Disability – Dearborn, MI

● Responsible for the investigation, documentation, and authorization of Short Term Disability claims for

group policy holders.

● Obtained objective medical, treatment plans, co-morbidities, medications, and diagnostic testing results to

ensure the patient is compliant with prescribed treatment for all medical certification within set maximum

guidelines.

● Responsible for evaluating occupational and non-occupational claims with purpose of determining fraud or

abuse.

● Maintained 100% compliance within ERISA guidelines.

Adjustment Specialist

September 2005 to December 2008

Unicare Life and Disability – Dearborn, MI

● Processed payments for short and long term group policy holders.

● Recalculated over and under paid claims to ensure customer satisfaction, and client bookkeeping.

● Organized tax information from W-2, W-4, and 1099 forms to ensure W-9's were sent out by federal

guidelines.

● Ran W2 tapes on Inquiries, created credit to Benefit Letters, and Performed all testing for ALICS, DCM &

MDA implementation.

● Maintained 99% financial accuracy based on statements of work.

Medical Leave Intake Specialist

May 2002 to August 2005

Unicare Life and Disability – Dearborn, MI

● Answered high volume inbound calls to receive and provide accurate information in regards to opening

medical leaves/disability claims for FMC employees.

● Ensured medical leave information is provided to appropriate plants and FMC benefit representatives in a

timely manner for claim awareness.

● Received several positive surveys for providing the best in class customer service to UniCare

disability customers.

● Lead unit in least dropped call rate with under 2% dropped calls in a 16,000 active claim count

environment.

Education

Alcorn State University 1996

Lorman, MS, USA

Psychology

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