Customer Service Medical

Linda A. Rock

**** **** ***** ******

Richmond Heights, MO 63117

314-***-****

**********@***.***

Objective: To utilize my extensive health insurance knowledge and excellent research abilities to resolve medical insurance complaints from members, providers, guarantors, and 3rd party clients. I am well versed in multiple aspects of the health insurance industry. I have Accounting & Finance skills from my 10 years in the United States Air Force. I possess excellent communication skills, both written and verbal in addition to solid computer skills.

Experience:

Nordstrom Rack November 2014 – present St. Louis, Missouri

I am the frontline contact for our customers in assisting with processing their purchases and answering their questions ensuring that their shopping experience has been outstanding in every way. I advise clients on the many benefits of the Nordstrom Rewards program and have consistently led my team in acquiring new Nordstrom Rewards members.

Grievance and Appeals Analyst May 1992 - March 1997 Blue Cross Blue Shield St. Louis, MO

Researched and resolved time-sensitive health insurance inquiries to include Missouri Department of Insurance complaints, ERISA Appeals, Congressional inquiries, Better Business Bureau requests, Provider complaints, and Legal issues; Responded in writing to the complainant detailing the cause and subsequent resolution of the problem which required extensive knowledge of operations to include Marketing, Claims Processing, Underwriting, Provider Relations, Membership, Medical guidelines, Legal issues, and Corporate Policy. Interacted with physicians, attorneys, underwriters, and marketing executives to ensure that procedures were implemented to prevent future reoccurrence of the problem which caused the initial complaint

Client Service Phone Representative May 1989 - May 1992 Blue Cross Blue Shield St. Louis, Missouri

I answered calls from clients who had questions and concerns about their health insurance benefits with regards to claims processing and membership guidelines. If warranted, I would resolve the problem and provide them with the necessary healthcare information that they requested.

Accounting and Finance /Disbursing Agent March 1979 - December 1989 United States Air Force

Accounted and certified Air Force funds to ensure precise accountability for Resource Managers to manage funds; Provided customer service to USAF soldiers with military pay transactions; computed travel vouchers; balanced daily Military Accounts Financial Resolution accounts using spreadsheets to reconcile balances to zero; handled currency disbursements – both Foreign and domestic. I opened an award winning Disbursing Agent Office in Pruem Germany with limited resources and funds.

Summary of Qualifications and Skills: Focused team player with recognized strengths in problem resolution. I have kept current on the many changing aspects of the healthcare industry over the last several years with my participation in many various medical organizations in order to be current on the all of the new changes that have taken place in the healthcare industry.