Customer Service Medical Claims
Resume:
EMPLOYMENT HISTORY
Retail sales associate, Once Upon a Child, Exton, PA
• Tagged, hung, filed, and merchandised clothing• Handled large sums of cash• Provided quick and efficient service to customers• Provided backup assistance to fellow workers
Collaborate with the buying team to identify trends and popular items in the children's apparel market and recommend adjustments to the store's inventory accordingly.
SEP, 1989 - MAY, 1998
Medical claims examiner, United Healthcare, Fogelsville, PA Reviewed and paid medical claims for AARP members
Communicated with physicians, hospitals, and other healthcare providers to establish eligibility Maintained production and quality requirements
Consistently exceeded expectations for quality and production requirements Earned Examiner of the Month on more than one occasion Analyze, investigate, and resolve complex medical claims Apply medical coding guidelines and reimbursement policies to accurately determine claim eligibility and payment amounts Identify opportunities to improve claims processing efficiency and accuracy Identify and report any fraudulent or suspicious claims in accordance with company policies and procedures Collaborate with cross-functional teams, such as customer service and provider relations, to ensure accurate and timely processing of medical claims
DEC, 1999 - JUL, 2008
Server, Morgan's Restaurant, Allentown, PA
Upsell menu items and promotions to increase sales revenue. Implement upselling techniques to increase sales and revenue for the restaurant. Provide exceptional customer service to ensure a positive dining experience and encourage repeat business. Create personalized dining experiences for each guest by making recommendations based on their preferences and dietary restrictions.
Maintain a clean and organized work area to ensure a pleasant dining atmosphere. Collaborate with kitchen staff to ensure timely and accurate delivery of orders SKILLS
Communication Problem-solving
Adaptability Empathy
Cash Handling Medical Claims Review
Customer Satisfaction Customer Service
Organizational Skills Time Management
1856 Highland Drive, Gloucester Point,
United States, 23062
ad46eg@r.postjobfree.com
CATHY LUCIANO
RECEPTIONIST / CUSTOMER SERVICE
PROFESSIONAL SUMMARY
Experienced receptionist with 6+ years of customer service experience. Skilled in adapting to various situations and communicating effectively with all types of people. Known for excellent verbal and written communication skills. A valuable asset to any organization seeking to provide exceptional customer service. REFERENCES
CATHLEEN LUCIANO
ONCE UPON A CHILD EXTON, PA
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