Customer Service Management
Resume:
TEAMICIA GREENE
**** *** ***** ****, ****** Mills, Maryland 21117 443-***-**** acb3u2@r.postjobfree.com
CLAIMS MANAGEMENT BUSINESS PROCESS ANALYST HEALTH INSURANCE SPECIALIST
PROFILE
Highly dynamic and motivated professional, o ering extensive years in claims management. Adept at
accomplishing a variety of duties, including e ective planning, reporting, and sta management to
obtain operational objectives as well as to improve productivity, client service, and overall performance.
E ective at providing assistance to the team within fast-paced and demanding work environments.
Exceptionally skilled at improving processes and executing cost control measures.
Expert at demonstrating excellent problem-solving skills and keen eye for detail.
Known for excellent interpersonal skills in interacting with clients, sta , and other business partners
to establish a foundation and relationship that fosters growth and understanding.
Equipped with knowledge of Medicare and Medicaid Services (CMS).
Proficient with Microsoft O fice Suite (Word, Excel, PowerPoint and Outlook).
AREAS OF EXPERTISE
Regulatory Compliance Training and Development
Claims Management and Analysis Interpersonal Coordination
Events Planning and Implementation Leadership and Team Building
PROFESSIONAL EXPERIENCE
STATE FARM INSURANCE COMPANIES FREDERICK, MD
2000–Present
Claims Processor
Serve as the medical claims processor for policyholders and insurers; take charge of processing
injury claims for several jurisdictions across the Mid-Atlantic region.
Utilize wide-ranging familiarity of insurance contracts and endorsements associated with injury
claims.
Collaborate with physicians and other healthcare providers to e ectively identify procedural and
diagnostic codes.
Thoroughly examine claims to define company’s scope of responsibility.
Take charge of approving and negotiating payments with claimants in conformity with policy
provisions.
Obtain comprehensive knowledge in personal injury protection, total loss, salvage, subrogation, and
comprehensive and collision coverage.
Evaluate Medicare claim reporting tool (MCRT) report submission to ensure accuracy and adherence
to Federal Medicaid and SCHIP Extension Act of 2007 (MMSEA) section III.
Maintain proactive involvement in conference calls to keep abreast of medical claims regulations.
Play a key role as a Medicare Claim Trainer for zone and new employees.
Facilitate team meetings to elaborate claim processing requirements for Medicare.
Display strong command in utilizing ICD-9 CM and CPT books.
Notable Contributions:
E ectively led a team in providing substantial contributions to the $9.2M recovered at the end of
2012.
Demonstrated exemplary performance in providing high-quality customer service which
significantly brought approximately 100% answer rate; delivering excellent skills in positioning the
unit in the #2 position with Agent Draft Authority claim.
Initiated the implementation of State Farm’s objectives and instituted methods of claim handling.
Proactively functioned in the fire consolidated claims, aiding 1,400 agency partners handling
updated claims, policy information, coverage questions, and payment reconciliation.
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TEAMICIA GREENE
9887 Bon Haven Lane, Owings Mills, Maryland 21117 443-***-**** acb3u2@r.postjobfree.com
EDUCATION AND CREDENTIALS
Associate of Applied Science in Business and Marketing Management, In Progress
Expected Date of Completion: Spring 2014
Atlanta Technical College, Atlanta, GA
Relevant Coursework:
Introduction to Marketing Business Math Principles of Management Business Regulations and
Compliance Visual Merchandising Introduction to Microcomputers Performance Management
Human Resource Management
Health Services Management Certification, In Progress
THE COMMUNITY COLLEGE OF BALTIMORE COUNTY, BALTIMORE, MD
Relevant Coursework:
Composition & Rhetoric Introduction to Criminology Medical Terminology Principles of Supervision
Seminar in Supervisory Problem Introduction to Law General Psychology Speech Fundamentals
Adjuster License: Delaware (Valid Until: Feb, 2015)
National Technical Honors Society
PROFESSIONAL TRAINING
State Farm Fire Comprehensive Examination
State Farm Auto Claim Processor School
Fire Consolidated Claims
Pictorial Learning Program of State Farm Insurance
Web-Based Training, Centers for Medicare and Medicaid
National Insurance Crime Training Academy
CERTIFICATIONS
Interpreting Medical Reports
Medical Test and Signs
Medical Management Course Series
Legal Concepts and Doctrines
Auto Physical Damage Basics
Claims Basics
Property-Casualty Principles
Avoiding Medicare Fraud and Abuse
Medical Necessity
Diagnosis Coding Using the ICD-9-CM
Uniform Billing UB-04
Skilled Nursing Facility Consolidated Billing
CMS Form 1500
Intro to Insurance Fraud Investigations
Training Theory & Skills for Fraud Investigators
Body Shop Fraud
Casualty Insurance Fraud
Intro to Medical Billing Fraud
Workers Compensation Fraud
PROFESSIONAL AFFILIATIONS
Community Events Chair, African-American Forum
Member, Policy and Procedures Committee
Member, Southern Zone Focus Group
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