Customer Service Representative/ Claims Correspondance
Resume:
Arleather Bullard-Amparado
Amityville, NY 11701
Phone: 631-***-****
Email: *********.*******@*****.***
OBJECTIVE Seeking a position within a company where I will be able to utilize my talents and strengths.
QUALIFICATIONS Registered Family Care Provider
Prepare monthly reports for social workers visits.
Administer medication.
Transport to doctor’s appointments.
Assists with daily routines.
EDUCATION Empire State College, New York
B.A. in Community and Human Services May 2013
EXPERIENCE Royal Heath Care, Hauppauge, NY
05/12-7/15 Claims Correspondence Coordinator
Provide world-class services to our providers by responding to provider issues and inquires that are received via telephone.
Examine data entry, calculate and adjudicate insurance claims in compliance with federal, state, and county laws.
Review, research, and respond to daily correspondence received from providers.
Respond to written inquires from our providers and plan representatives.
Maintain individual production count.
Adjust finalized claims for correct reimbursement, claims correction and errors.
Complete projects as assigned.
0/8-05/12 Provider Service Advocate
Provide world-class service to our providers by responding to providers issues and inquires that are received via telephone.
Review, research and respond to inquires from providers.
Identify issues based on provider inquires.
Analyze database to identify problems/issues pertaining to claims processing.
Document computer system to track inquiry.
Complete projects as assigned.
USI Administrators, Melville, NY
01/01-01/02 Customer Service Representative
Handled incoming calls from participants and providers
Verified benefits.
Documented calls and followed up on customers’ requests.
Produced correspondence for customers.
Empire Blue Cross and Blue Shield, Melville, NY
09/98-01/01 Customer Service Representative
Received and responded to telephone and written inquires.
Processed claims.
Verified benefits.
Reviewed group billing and generated group bills.
SKILLS
Strong planning, organizing and prioritizing skills.
Excellent communication and conflict resolution skills.
Excellent customer service skills via telephone.
Excellent data-entry and data collection skills.
Ability to multi-tasks.
Strong computer skills.
ACHIEVEMENTS
Received a promotion at Royal Health Care.
REFERENCES
Furnished upon request.
Contact this candidate