Blue Cross Blue Shield Florence, SC
Claims Processor I April 2015 to Present
• Resolves medical claims by approving or denying documents
• Protects operations by keeping all claims information confidential
• Thoroughly reviewing all claims to ensure that there is no missing or incomplete information submitted
• Enter claims into the computer system utilizing knowledge of CPT codes and ICD 9-10 codes
• Record any changes made to claims submitted (if any) on WLMU
• Authenticate the information on all medical claims received
• Great communication skills
• Keeps work area clean
• Resolve issues (if any) in a timely manner
• Meeting production as well as quality goals
• Verify that each patient has coverage for the dates of services rendered
• Understanding the client’s needs
• Correctly reading and assessing medical documents
ADP (Kelly Services) Florence, SC
PSN Coordinator March 2014 to April 2015
• Reviewed inbound tax credits forms containing confidential information to update corresponding records in Vista
• Using online sources to support program eligibility and form submissions
• Responsible for quality completion of tax credit form packages in accordance with the WOTC program guidelines
• Worked under constant and conflicting deadlines producing tax credit form packages within strict deadlines for SWA submission utilizing state file transfer or Certificates of Mailing for each state.
• Maintained an updated knowledge of rules and regulations governing WOTC program eligibility as well as state specific SWA requirement.
Assurant Specialty Property Florence, SC
Hazard Insurance Processor August 2013 to March 2014
• Updated hazard insurance lines on the clients servicing system.
• Verified that the policy contains acceptable coverage and disburse premium payments from the escrow account if required.
• Made 64 or more outbound phone calls to insurance agents, and companies to update hazard insurance policies and obtain needed (missing) information on a daily basis.
• Performed maintenance as necessary for policy changes, letters, notices, etc. Insure all items are processed in a timely manner to meet or exceed established standards.
• Reviewed various types of insurance documents and update the hazard insurance lines on the clients servicing system according to established procedures.
• Met/exceeded production on a daily basis.
• Met KPI on a monthly basis.
• Assisted with ten or more inbound phone calls daily.
• Faxed and copied policies going out to agents and/or insurance companies.
• Assisted with customer service calls.
• Detail oriented to honor the Assurant promise to our customers.
• Adapted easily as procedures/client needs changed.
• Excellent organization skills.
• Ability to analyze data.
Florence Family Y.M.C.A Florence, SC
Child Care Worker/Office Assistant June 2005 to August 2014
• Updated and maintained databases such as mailing lists, contact lists, and client information.
• Ensured the comfort and seeing to the needs of the parents as well as children.
• Maintained office filing and storage systems.
• Updated and maintained internal staff contact list.
• Spearheaded in decision making.
• Kept office clean and tidy.
• Answered phone calls and returning voice messages daily.
• Faxed, scanned, and copied documents daily.
ADP Security Clearance with the Defense Health Agency 2013