Customer Service Representative
Resume:
Theresa Murphy
Experienced professional seeking challenging career where my skills, experience and
willingness to learn will be utilized.
Holmes, PA 19043
**********@************.*******.***
Motivated, mature professional seeking to gain a position where my skills, knowledge and experience can be utilized. I have a “can-do” attitude and enjoy learning new things. I work well both independently and in a team environment.
Authorized to work in the US for any employer
Work Experience
Customer Service Representative
UnitedHealth Group - Remote
March 2023 to Present
• Handle inbound calls in a timely and accurate manner to achieve first call resolution.
• Make outbound calls as needed to ascertain insurance information to file corrected claims.
• Review denied claims by Medicare for proper coding and work with physicians to identify errors.
• Communicate with insurance companies to ensure claims are filed according to the plan rules and resubmit as needed.
Senior Customer Service Representative
Zotec Partners - Remote
July 2021 to February 2023
• Handle inbound calls from patients as well as doctors, insurance companies and lawyers.
• Assisted patients in filing claims with insurance companies, working with insurance companies to resubmit denied claims and provide proper ICD-10 coding needed to file Medicare claims. Customer Service Representative
Optum 360 United Healthcare - Remote
April 2019 to July 2021
Answer inbound calls in a timely manner and provide high level customer service to callers. Met or exceeded all metrics and acted as liaison between patients and providers. Manager
Keystone First - Philadelphia, PA
April 2008 to December 2011
• Managed a large call center handling inbound calls from members and providers
• Managed Enrollment and ensuring that all members were enrolled in a timely and effective process.
• Communicate with staff on progress and areas for improvement and made action plans to ensure compliance and improvement
• Handled claims and claim adjustments procedures to improve timely payment
• Managed budget and hired staff as needed
Manager
Independence Blue Cross - Philadelphia, PA
August 1998 to January 2008
• Managed claims, call center, claims processing and other related functions and reported to Sr Management
• Integral part of workforce where our goal was to create a plan for rolling out a new system for the team
• Handled staff scheduling to ensure coverage
• Worked closely with negotiation of fee schedules for providers Education
M.B.A. in Business
St David’s University - Radnor, PA
August 2000 to June 2001
Bachelor's degree in Communications
Penn State - University Park, PA
August 1992 to June 1996
High school diploma
Springfield High School - Springfield, PA
September 1989 to June 1992
Skills
• Medical terminology
• Phone etiquette
• Customer service
• English
• Data entry
• Medical office experience
• Analysis skills
• Communication skills
• Medical Coding
• EMR Systems
• Medical Billing
• ICD-10
• Insurance Verification
• Accounts Receivable
• ICD-9
• Medical Records
• CPT Coding
Certifications and Licenses
Medical Terminology
Present
ICD11
Received my certification in ICD-10 and ICD-11 Coding. HIPAA Compliance Certification
MBA Heathcare Administraton
September 1998 to June 2001
Additional Information
Certificate in Medical Billing and Coding for ICD-10 coding to process claims for payment by Medicare, Medicaid and commercial insurance companies.
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