Customer Service Representative

Resume

Certified Medical Billing & Coding Specialist

Dental Claims Processing

CMS 1500

ICD 9 CM & ICD 10 CM

CPT

Health Industry Customer Service

Exceptional Communication Skills

Medical Terminology

HIPAA

COBRA

PC and Macintosh Operating Systems

MS Office

Self-Motivated

Goal Oriented

Experience

Group Resources Inc, Duluth, GA 2000 - 2016

Member Service Representative

Served as an administrative liaison for self insured plans and state government owned accounts.

Handled the tasks of verifying client status and perform follow-up of clients through calls and e-mails.

Personally responsible for accounts that range in value from $50,000 to $1,000.000.

Processed enrollment changes and terminations while maintaining eligibility production data files.

Handled private COBRA and government HIPAA administration.

Provided customer service and technical support with IT in problem resolution with delicate medical issues.

Produced monthly client billing invoices and individual identification cards.

Trained new company Member Service Representatives and provided guidance on procedures and policies.

Maintained quality control seeking new ways to improve customer service.

Quickly and effectively solved customer challenges to include following up to ensure remediation.

Anthem Health and Life, Duluth, GA 1996 – 2000

Dental Claims Processor

Responsible for examining and processing patient dental claims.

Handled adjustments and any discrepancies identified including billing errors.

Verified billing coding compliance in accordance with set performance and standards.

Monitored internal and external customer and member service claims questions, concerns and related issues while maintaining a superior level of accuracy.

U.S. Military 1983 - 1988

United States Navy, Petty Officer Second Class. Served with honor 1983-1988

Culinary Arts School, Naval Training Center, San Diego, CA, 1983

Good Conduct Award given in 1987, Honorable Discharge granted in 1988

Education

Bergen Blended Academy, Hasbrouck Heights, NJ 2016

Certified Medical Billing & Coding Specialist (CBCS)

NHA Certification # PB9T9M2K3

http://www.linkedin.com/in/helen-ramos-b9288a106

References Furnished Upon Request

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