Data Entry Customer Service
Resume:
Jorge Matos
Land O Lakes, FL *****
*****.*********@*****.***
OBJECTIVE
Experienced office management customer service and administrative professional optimizing productivity, efficiency, and service quality across various environments. Highly dependable, ethical and reliable support specialist and leader that blends advanced organizational, technical and business acumen. Works effectively with cross-functional teams in ensuring operational and service excellence. Proficient in Tru-care, Amyis,Portico, omni, Power Bi, File-net,MS Excel, Workday and spreadsheet, data entry abilities.
CAREER OBJECTIVE
Seeking a fast paced, energetic environment to excel and advance professionally in order to use my leadership abilities to the optimum level abilities to assist in projects. SKILLS
Data Entry and Management Medical Recordkeeping
Self-motivated Proficient in Microsoft Medical Records Review Tru-care,Tru-cloud, File-net
Collecting Intake Information Document Scanning
Clerical Support English & Portuguese
Admissions Processes
Problem solving excellent communication
Project management resolution
EXPERIENCE
Centene, Tampa FL- Authorization Specialist III
July 2022 - PRESENT
● Provided customer service in a high pace contract center environment over the phone, via live chat and emails.
● Maintained records and documentation for Medicare and Medicaid insurance claims
● Investigates problems of an unusual nature in responsibility to identify root cause.Present proposed solution in a clear and concise manner to leadership proficiently managed the processing of Marketplace, Medicare and Medicaid to insurance claims, ensuring accuracy and timeliness throughout the entire procedure.
● Triage unsupported que, to ensure cases appointed to reps timely determine coverage if any and the impact on the future coverage of the client
● Knowledge of ICD-9/10, Cpt coding, HPIC coding modifiers and DMHC regulation Proficient in marketplace,medicaid,and medicare practice enter all data into computer system for future reference
Centene, Tampa FL- Referral Specialist I
October 2021-July 2022
● Assesses caseload and realigns assignments to meet organizational needs.
● Spearheaded clerical intake data entry responsibilities, meticulously organizing various incoming documents such as Appeals, Grievances, Pharmacy requests, Claim Correspondence and Medical Records.
● Thrived in a dynamic, fast-paced environment by adeptly multitasking and delegating tasks, exhibiting strong decisions- making abilities in high-pressure situations acted as liaison between hospitals, physicians, health plans vendors and entered all data into the computer system for future reference.
● Initiate authorization request for outpatient and elective inpatient service in accordance with prior authorization list.
Well Care, Tampa FL - Care coordinator
January 2018-October 2021
● Proficiently performed data entry tasks, ensuring accuracy and efficiency in processing crucial information
● Assists, completes and submits special projects and includes such as Appeals and Denials report or assignment to meet department functionality to support document management needs. assisted caseloads and realigns assignment to meet organizational needs
● Performed outbound calls to provide status to members for patient-in house
/approved and denial
● Assisted with claims, intake, enrollment, and member services to resolve member and provider issues.
● Interacts with other departments to assist with special projects as directed by the supervisor.
Well Care, Tampa FL - Intake Specialist
December 2012-January 2018
● Operated company vehicle in the capacity of picking up and dropping off mail correspondence.
● Validate data in using data entry skill
● Assisted with customer service
● Assisted with special projects Tracker & Toolbox,
● Assisted with Appeals,and Grievance, PLP, and processes the claim projects.
● Produced reports and documents for the senior team.
● Sort mail and log and scanned mail to the supporting documention.
● Assisted caseloads and realigned assignments to meet organizational needs.
Education
Eastern Alamance High School Mebane NC General Studies High School diploma
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