Customer Service Des Moines

Des Moines, IA ***** 515-***-**** ***********@*****.***

TRACI RICCIO RICE

I am an experienced, efficient employee with 30 years experience mostly in HR or Insurance fields.

I continue to build skills and tackle new responsibilities with great energy due to learning something new in a field that never stops changing. I have extensive knowledge in Insurance benefits, including life, property, casualty, workman compensation, health and billing of claims.

I am familiar with accounting and billing principles needed to do multiple tasks in different positions.

I enjoy contributing to individual and team success through hard work, attention to detail and excellent organizational skills.

I stay motivated to continue to learn and grow in any position that I have PROFESSIONAL

SUMMARY

SKILLS Investigative techniques

knowledge

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● Account balancing

● Researching abilities

Basic accounting

principles

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● Account discrepancies

● Conflict resolution

● Computer proficiency

● Teamwork

● Computer skills

Invoice Documentation

Management

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● Billing and Invoicing

● Error Revision

● Account Posting

● Discrepancy Resolution

Verbal and Written

Communication

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● Microsoft Office & Excel

Work Planning and

Prioritization

●

● Customer Service

Organization and

Prioritization

●

● Benefits Administration

Data Compiling and

Verification

●

● Critical Thinking

● Decision Making

Work Planning and

Prioritization

●

● Database Maintenance

Check Encoding and

Canceling

●

● Customer Service

Organization and

Prioritization

●

● Pay Adjustments

Wages and Deduction

Calculation

●

● Time Tracking and Review

Employee File

Maintenance

●

Work Planning and

Prioritization

●

● Database Maintenance

Check Encoding and

Canceling

●

● Customer Service

● Discrepancy Reconciliation

Organization and

Prioritization

●

● Benefits Administration

Data Compiling and

Verification

●

● Pay Adjustments

● Critical Thinking

Wages and Deduction

Calculation

●

● Time Tracking and Review

Employee File

Maintenance

●

● Decision Making

● Work Planning

BILLING REVENUE SPECIALIST 03/2017 to Current

Pur Foods / Moms Meals, Ankeny, IA

WORK HISTORY

FIXED ANNUITY SPECIALIST 02/2010 to 08/2015

Voya / ING Financial, Des Moines, IA

STARBUCKS BARISTA TRAINER 04/2005 to 05/2013

Starbucks/Starbucks Hyvee, Grimes, IA

PROVIDER SERVICES SPECIALIST 07/2001 to 04/2009

BCBS Of IA / Wellmark, Des Moines, IA

Reviewing clients eligibility, authorizations, authorizations dates for clients to receive meals.

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Billing for all State of PA DHS Medicaid clients, UPMC/Medicaid, Keystone/Amerihealth, and Pace agencies.

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Process pre-work to insure proper billing is submitted, work through eligibility issues if needed. Request documentation if needed to show authorization confirmation and/or eligibility.

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Process claim rejections, denials. Keep communication open with contacts at agencies to insure problems or questions are dealt with on timely matter.

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● Communicate either by phone or email to agencies requesting verification of coverage

● Track aging for agencies and insure it is current and payments are being received on time.

● Conducted call audits to assess interaction quality, accuracy and service success.

● Conducted research, gathered information from multiple sources and presented results. Verified completeness of provided details when processing Medicaid coverages available to clients

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Dependable, team player, lead person that worked independently with a Denial Specialist and PA Team/Agencies.

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● Assist with HR Benefits and Work Comp Insurance duties when position was vacant Assisted members via phone or email with questions, instructions, changes to their accounts.

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● Processed withdrawal requests to be sent out.

● Discussed with customers to provide information about available products and policies. Conducted annual reviews of existing policies to update information. Determined financial needs by assessing existing coverage and aligning new products and services with long-term goals.

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Worked to accommodate new and different insurance requests and explored new value opportunities to optimize clients experiences.

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● Conducted annual reviews of existing policies to update information. This was an on call as needed position that allowed to watch my grandchildren most of the time and help out family.

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● Continued to train/on call when needed as I worked regular job. In this position I would go into stores / new locations and teach the Baristas how to : Customized training strategies based o

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● Individual barista knowledge, experience and strengths. Taught new drinks and procedures first, and instructed all team members on how to properly complete each.

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Created wide variety of hot and cold drinks in average shifts with consistently positive customer satisfaction scores.

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● Maintained supply levels in counter and customer areas to meet typical demands. Maintained espresso equipment and performed minor repairs to keep coffee machines functioning properly.

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● Taught proper procedures and strategies for success to new employees PROPERTY & CASUALTY CLAIMS SPECIALIST 01/1999 to 07/2001 Allied / Nationwide Insurance, West Des Moines, IA OFFICE MANAGER 09/1990 to 11/1999

EMSI, Des Moines, Ia

INTAKE /UNDERWRITING SUPPORT SPECIALIST 01/1987 to 09/1990 American Mutual Life, Des Moines, IA

Took high number of incoming calls from Drs offices or members verifying benefits, coverages, correct way to file claims re: CPT or ICD coding.

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● Assisted Delta Dental with Claims, and benefits/coverages.

● Developed and sustained daily tracking spreadsheets of calls and benefit questions Assisted other departments when needed - verifying claims or benefits for UPMC or Medicare coverages or claims

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● Implemented and assisted with training of procedure changes Kept in contact with Clients/Drs offices via phone or email and verified documentation on file

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Assisted with training on new system when BCBS went from DOS system to Internet system

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● Received property and casualty claims via queue or phone

● Reviewed information for facts, situations that occur, damages that were being claimed

● Requested information needed to solve claims properly and timely matters

● Communicated with policy holders, residents, drivers effectively and timely

● Managed property documents needed for permanent records if needed Conducted inspections of property or vehicles to identify concerns and direct and request repairs in timely matters

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● Collected records of payments and payment dates

● Assisted clients with understanding their benefits and coverages

● Testified in court when needed - prepared and processed - won all 3 times

● Assisted team members with claims or projects

Started out as Call Center Representative and moved up to Supervisor in 1993 and then Office Manager in 1995

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● Assisted in developing standard operating procedures for all employees

● Arranged office meetings for updates and team coaching

● Offered ongoing coaching and motivation - created incentives for team morale.

● Oversaw quality control and productivity

● Oversaw benefits and payroll

● Sourced and communicated vendors for projects and contracts

● Coached new hires on company processes

● Coordinated special projects and managed schedules

● Managed CRM training, troubleshooting, updates and reports

● Reviewed applications for insurance coverage and reports from loss control

● Supported review and acceptance or denial of new or renewal applications Assisted level of assistance to different team members to insure all information was received to be reviewed

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● Communicated via phone or email to necessary entities to receive necessary documents

● File and document information received

East High School, Des Moines

High School Diploma, 06/1985

EDUCATION

Certified in CPT Coding / ICD Coding

Loma 1 & 2

AAHAM Certification I

Benefits Training

Hippa Training Experience

Medical Terminology Certification

HR Basic/ Office Operations / Payroll & Benefits

CERTIFICATIONS

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