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Customer Service Medical Claims

Location:
Tampa, FL
Salary:
18
Posted:
March 23, 2024

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Resume:

TRICIA A. MUELLER

Tampa, FL ***** 813-***-**** ad4izd@r.postjobfree.com

Experienced in pleasing the customer with expertise in advising them of all that can be done for them. Keep up with latest changes to the work that is at hand and techniques that the employer expects from me. Maintain proficiency with industry software and tools. Committed professional who will provide excellent customer service and works to carry out events to highest of standards. Knowledgeable and experienced in making the customer happy as before walking out the door. Also adept at problem-solving. Media Relations

Fundraising

Contract Execution

Locating Venues

Teambuilding

Written Communication

Problem-Solving

Good Telephone Etiquette

Attention to Detail

Self-Motivated

ASSISTANT FOR PLANNING EVENTS

Leading Ladies of Ruth Eckerd Hall

Fundraising, Assisting High School graduates with college tuition sending teachers to volunteer after school programs for music lessons.

Dog Walker, 01/2020 - 04/2023

Various Neighbooring Clients – Tampa, FL

Fed, walked and cared for dogs during owners' absences and out-of-town trips. Led dogs away from hazards, obstacles and other animals to protect safety. Developed strong personal relationships and trust with dogs through vocal affirmations, petting and pre-approved treats.

Followed optimal schedules for animals as set by owners or supervisors. Developed strong personal relationships and trust with dogs through vocal affirmations, petting, and pre-approved treats

Fed, walked, and cared for dogs during owners' absences and out-of-town trips Greeted pet owners warmly to build trust and create lasting relationships Monitored weather conditions before walks to avoid dangerous temperatures for dogs Led dogs away from hazards, obstacles, and other animals to protect safety Patient Care Taker, 03/2018 - 01/2020

Joanne L. Mueller – Tampa, FL

Assisted with feeding and monitored intake to help patients achieve nutritional objectives. Answered patient assistance calls, assessed needs and offered qualified support. PROFESSIONAL SUMMARY

SKILLS

WORK HISTORY

Obtained patient vital signs and reported results to staff nurse or physician, noting changes from prior measurements.

Maximized patient satisfaction by helping individuals carry out personal tasks such as dressing and walking.

Monitored, tracked and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.

Helped patients maintain healthy skin by checking wounds, assessing integrity and bathing bedbound individuals.

Organized and replenished unit supplies to maintain team readiness for expected demands Medical Claims Specialist, 09/2015 - 02/2018

First Source Transcation – Tampa, FL

Processed medical claims for the following states: CA, FL and GA using current state guidelines Identified

UB and HCFA claim forms

Verified all information pertaining to the adjudication of the claim Maintain a clear understanding of prior authorizations required to determine if the claims shall be paid or denied as well as verifying all CPT codes and ICD 19 codes. Submitted electronic/paper claims documentation for timely filing. Managed large volume of medical claims on daily basis. Paid or denied medical claims based upon established claims processing criteria. Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.

Submitted electronic/paper claims documentation for timely filing Used administrative guidelines as resource or to answer questions when processing medical claims Responded to correspondence from insurance companies Reviewed provider coding information to report services and verify correctness Customer Service Associate, 01/2014 - 08/2015

Winn Technology Group Inc – Palm Harbor, FL

Helped large volume of customers every day with positive attitude and focus on customer satisfaction. Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.

Offered advice and assistance to customers, paying attention to special needs or wants Responded to customer calls and emails to answer questions about products and services Informed customers about special promotions and provided detailed information for various products Answered customer telephone calls promptly to avoid on-hold wait times Kept detailed records of customer interactions to track and resolve issues quickly Actively listened to customers, handled concerns quickly and escalated major issues to supervisor Increased revenue by cross-selling and upselling products and services Medical Assistant, Patient Care Technician, Phlebotomy Technician, CNA I and CNA II Isothermal Community College - Columbus, SC

Studies included: Venipuncture, capillary puncture and urinalysis using therapeutic communication skills. Telecommunications, scheduling and electrocardiography. Dosage, administration and accounting procedures EDUCATION

for medication. In depth care of adult and geriatric resident emergency procedures and first aid clinician. Medical records management including: Billing and collections. Communication: medical terminology, exceptional verbal, writing and interpersonal skills. Healthcare Associates Degree: Medical Billing And Coding, 08/2021 Hillsborough Community College - Tampa, FL



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