Customer Service Data Entry
Resume:
Elaina Velasquez
*******************@*****.***
PROFESSIONAL SUMMARY
Self-motivated and detail-oriented office professional seeking a new opportunity to positively
contribute to the work environment. Received the Builder Award for motivating change in Fresno County, by volunteering and helping build multiple parks in Fresno County. Received award for the highest net promoting score for 4 consecutive months at Aetna.
SKILLS
Microsoft Word Google Docs Microsoft Excel Scheduling Billing Insurance Verification
Claims Adjusting & Follow Up Multiline Phones Phone Etiquette Customer Service Invoicing
Ordering Supplies High Volume Calls Data Entry Purchase Orders Medical Terminology
PROFESSIONAL EXPERIENCE
Claims Examiner
Advantek Benefit Administrators
March 2024 – September 2024
•Process CMS-1500 claims, UB-04 claims, high-dollar claims, and JAA/BlueCard claims
•Interpret group SPD’s and apply benefits
•Review/create/process and maintain various reports
•Access Anthem Blue Cross website for inquiries
•Batch/Scan correspondence
•Track and work spreadsheets for special projects
•Maintain Claim Inventory turnaround time within acceptable levels
Dental Receptionist
Central Valley Indian Health
December 2020 - December 2023
•Greeting patients as they arrive and answering the phones.
•High Volume scheduling and cancelling patient appointments.
•Dental Charting and Treatment Planning.
•Completing and filing insurance forms and dental billing records.
•Translating dental services into proper billable codes.
•Managing office inventory and supplies.
•Communicating with dental supply vendors.
•Handling test results including x-rays.
Office duties including document filing, scanning, and creation
Collect payment
End of day bank deposits/verification
Customer Service Representative
Aetna – Fresno, CA
December 2018 – January 2021
•Provide detailed and accurate information regarding members benefits and relay them to the
•provider/Hospitals.
•Looking up CPT codes and ICD 10 diagnosis code for claims and benefits.
•Provide details regarding claims for dates of service that have already transpired.
•Route mishandled calls and claims to appropriate stations, routes and work centers.
•Communicate daily and follow up with providers regarding complex medical issues.
Lead Instructor, Youth Job Prep Program
City of Fresno – Fresno, CA
September 2016 – December 2018
•Prepare high school students for the workforce by teaching and instructing skills such as resume building,
•application and interviewing skill, etc.
•Supervise and instruct students in a large clasroom setting.
•Organize and run graduation program for students.
•Plan, create, and distribute marketing materials.
EDUCATION
High School Diploma
Clovis High School – Clovis, CA
Child Development 14 ECE Units
Fresno City College – Fresno, CA
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