Customer Service Medical

Angela Tabbs

Phone 443-***-****

Email ***********@*****.***

SUMMARY

Twenty years of successful experience in administrative support with strengths in problem-solving and trouble-shooting.

Experience includes working with databases, mail merges, mailing data entry research. Possess an excellent working

knowledge using, Microsoft Excel, Power Point Microsoft Word, QNXT.

TECHNICAL SKILLS

Microsoft Word, Microsoft Excel, Microsoft Access, Microsoft PowerPoint, QNXT, ICD-9, Medical Terminology

PROFESSIONAL SKILLS

Baltimore Medical Systems 10/14-Present

Value Based Purchase Coordinator

• Verify insurance eligibility

• Assist with Priority Partner members schedule appointments.

• Help develop desktops and process to improve the daily workflow of getting member into care

• Coordinate with the different sites to ensure that members are still attending assigned site.

• Update and fax the necessary referrals over to Priority Partners Member Services unit.

AETNA 08/10-10/14

Hedis Coordinator

• Helped organize and supported Medical Record Review for three years.

• Data entry for Medical Record Review.

• Work directly with Postpartum, Diabetic Eye, Lead, Cervical Cancer Screening (PapSmear), SSI Adult, SSI Child, Well

Child 3-6 as well as Adolescent Well care members with a goal to ensure approximately 1500 members received

appropriate healthcare within a timely manner.

• Contact primary care providers, case managers to schedule appointments, verify scheduled appointments, insurance

verifier as well as confirm kept appointments for gift card incentive.

• Made 80 calls a day

• Collects and provides data to management for root cause analysis improving FCR/SAT for developing trends not

captured through the FCR database.

• Verify claims as well as submit claims for gift card incentives.

• Helped organize and support Medical Record Review for past three years.

• Data entry for Medical Record Review.

• Assistant two Nurses with research, and making calls and faxing for this year’s Medical Record Review for 2014

• Performs service recovery for the member and documents actions taken and required follow-up to resolve situation.

• Escalates issues accordingly when, further action requires secondary sources or more senior staff.

• Completes all required documentation in the database associated with survey input (including reason codes,

complaints, etc.).

• Documentation efforts also include MSW / HMO Event tracking.

• Actively participate in HEDIS clinic days and outreach activities.

• Make the necessary changes, by updating the Members information within the QNXT database while working from

home 4 days a week.

• Utilize system applications for tracking productivity as well as gathering information and troubleshooting the member

issues.

• Analyzed member files utilizing a variety of database systems, ICD-9 codes, and medical terminology to obtain

appropriate information needed to ensure resolution on the first call.

• Ability to maintain accuracy and production standards.

Lazy Boy Service Center 02/10-8/10

Customer Service Representative

• Called customers to reschedule service appointments.

• Answered phones.

• Scheduled service appointments.

• Handled customer inquiries on shop repairs.

• Worked within RMS System and ASAP.

• Entered data from tech’s service tickets.

• Worked with management on special projects.

Acme Paper 04/09-02/10

Data Specialist

• Processed customer credits daily.

• Ran IQ report for the daily deliveries.

• Work within co-star program daily.

• Ordered offices supplies.

• Ran Special IQ reports for sales.

• Work in Road Net to update time windows.

• Worked with the others to process the Richmond deliveries.

Solo Cup Company 11/06-04/09

Jr. Sales Analyst

• Processed customer claims.

• Monthly production was a $1,000,000,000 in claims.

• Resolved system discrepancies.

• Analyzed customer request for contract reimbursement.

• Determined the appropriate pricing contract for customer credits resolved discrepancies between customer’s credits

and correct contract pricing.

• Converted customer data to system readable format.

• Utilized MS Access database system to correct customers' data issues.

• Provided audit support for annual and quarterly financial audits.

Schaller Anderson of Maryland 10/03-10/06

Facilities Coordinator

• Managed a staff of two.

• Coordinated daily/weekly service schedules including contract work.

• Maintained records and prepared reports pertaining to areas of assignment.

• Met with vendors; prepared requisitions for all purchases, to include materials & supplies.

• Daily communications (written and oral) with all staff and the public.

• Ensured timely processing of office supply requisitions.

• Ensured confirmation and annotation of invoices and related paperwork.

• Maintained appropriate levels of in-house office supplies including printed materials and mailroom supplies.

• Responsible for equipment service/repair schedule.

• Worked with facility property management to ensure facility maintenance issues are quickly and efficiently resolved;

maintained facility checklist.

• Ensured all furniture, equipment, etc. is identified, asset tagged and logged for accurate inventory control in a timely

manner.

• Coordinated office moves (equipment/furniture) and installations.

• Coordinated the sorting and distribution of incoming mail.

• Processed daily outgoing mail including: packaging, batching, ensuring appropriate levels of postage are used.

• Arranged for courier services as needed.

• Served as back up switch-board operator.

• Assisted in preparation of performance evaluations.

EDUCATION & CERTIFCATION

University of Phoenix online

Associates of Arts, Information Technology Feb 2014

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