Customer Service Insurance Office Medical
Resume:
WORK EXPERIENCE
Liberty Mutual- Auto Property Damage Specialist
Liberty Lake, Washington
Februarys 2016-Current
Manage clients’ auto accident claim from beginning to end
Set clients up with rental reservations while reviewing coverage
Set appointments with auto shops for clients
Return emails and voicemails addressing concerns
Listen, understand and advised of the clients needed coverage
Determine fault on auto accidents
Keep proper electronic and paper files of claims updated and in order
Re-create auto accidents
Review county codes and statues regarding traffic laws
Coordinate coverage and investigations with other insurance carriers
Premera Blue Cross- Customer Service Associate NAO I-Amazon
Claims and Referral Specialist
May 2013- February 2016
Spokane, Washington
Listen to customer’s issues, and form a solution while updating the file
Effectively explain a member’s insurance benefits
Also explaining how a medical claim processed to benefits
Assist member’s flexible spending account and health savings account
Insure member is aware of all plan requirements
Ensure claims process correctly
Process claims in a timely fashion
Enter referrals from fax folders and emails from Outlook, faxes and calls
Manage referral files, fax folders and email box
Maintain communication with customer service on status of claims and referrals
Complete knowledge of insurances, pre-authorizations, referrals, authorization denials, claims denial codes and reasons, procedure and diagnosis codes, provider relations, provider agreements and contracts, allowed amounts and fee schedules.
Wal-Mart - Customer Service Supervisor
September 2012 – May 2013
Spokane, Valley Washington
Resolve customer complaints regarding sales and service.
Check to ensure the appropriate changes were made to resolve customers' problems
Refer unresolved customer grievances to designated departments for further investigation.
Provide customer service by greeting and assisting customers, and responding to customer inquiries and complaints.
Direct and supervise employees and assign specific duties.
Enforce safety, health, and security rules.
Keep daily records of cash handling.
Preform daily audits on registers.
Keep records of customer interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken.
Refer unresolved customer grievances to designated departments for further investigation.
Contact customers to respond to inquiries or to notify them of claim investigation results and any planned adjustments
EDUCATION
Apollo College
Degree: Medical Assisting
Skills: Front office Management: Patient check-in, insurance verification, some billing and coding, filing, answering phones.
Back office: X-rays, Provider assisted procedures, small scale lab tests, vitals.
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