Customer Service Administrative Assistant
Resume:
Loella A. Jones
Humble TX, *****
********@*****.***
Profile: Certified Billing and Coding Specialist, Certified Medical Administrative Assistant, with strong
knowledge of Medical Terminology. Proficient in Micro-soft office, 10 key, telephone etiquette; familiar
with FMLA laws, HIPAA laws and other acts that cover employer-employee and client related privacy.
Skills:
Insurance Verification Micro-soft
Processing Insurance forms 10 key
Greeting patients and visitors Medical Billing
Creating invoices Medical Terminology
Scheduling procedures Medical Coding
Translating codes Administrative Duties
Prepare claims documents CMS1500 forms, UB04
Submit Claims Knowledge of Medicare/Medicaid managed
Organize and track claims care/ workers comp
CPT and ICD-9 Codes
AETNA: Customer Service Associate: April 2014-Current
• Insurance verification
• Explanation of Benefits/coverage to both providers and members
• Explanation of E.O.B
• Explanation of claims and authorizations
• Explanation of claims paid and rejected
• Physician changes
• Update insurance information
• Update and process payment information
• Update and process address changes
• Enrollment information
• Dis-enroll and cancellations
• Process ID card request
• Pharmacy and Medication request
Customer Care Professional: UnitedHealth Care September 2013-October 2013
• Respond to complex customer calls
• Benefit and Eligibility information
• Billing and Payment issues
• Customer material requests
• Physician assignments
• Authorization for treatment
• Explanation of Benefits (EOB)
• Provide the very best customer service to internal/external customers.
• Consistently meet established productivity, schedule adherence, and quality standards
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• Processes claims according to specified procedures and standards, meeting all position production
and quality standards.
• Recognizes when to refer complicated claim situations to the various areas, outside firms and
organizations. Submits and monitors claims referred to internal support units.
• Determines if third party recovery or reimbursable compensation potential exists.
• Handles complex claim situations. Analyzes and resolves problems from customers and
providers. Selects and explains the best solution for the problem.
• Project work as assigned.
United Airlines: Flight Attendant February 2006-October 2011
Lamar University(Senior) 9/2014-
Business Administration
Education:
Houston Community College 2012
Administrative Medical Assisting
Medical Billing
Medical Coding
Medical Terminology
Certifications:
CMAA-Certified Medical Administrative Assistant
CBCS-Billing and Coding Specialist
Ramapo College of New Jersey 2001-2005 (Attended)
Major: Social Work
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