Customer Service Quality Improvement
Resume:
Kamisha Woodford
Available without Restraints
Columbus, GA 31904
***************@*****.***
I am a dedicated and skilled professional with experience in customer service and relationship management.
I am aiming to utilize my skills in customer interaction, problem resolution, and team leadership to enhance customer satisfaction and loyalty in a dynamic service environment. Willing to relocate: Anywhere
Authorized to work in the US for any employer
Work Experience
CSR II / PCA
Anthem Blue Cross BlueShield-Columbus, GA
November 2019 to September 2024
• Verified and entered patient demographics and insurance information into practice management software per HIPAA guidelines.
• Abstracted information from medical and or pharmacy records and assign appropriate codes, as necessary.
• Ensured claims are submitted in a timely manner for reprocessing and adjustments.
• Strived to complete each call per company time monitored guidelines.
• Posted charges, payments, as well as methods of payments.
• Understood insurance benefits including copays, deductibles, and coinsurance.
• Researched rejected and denied claims.
• Understood and applied medical terminology, ICD-10, CPT-4, & HCPCS coding guidelines & payer rules.
• Worked with physicians and others to ensure complete and accurate information and optimal reimbursement based on coding and guidelines.
• General training upgrades.
• Investigated claim and benefits and provide quotes of coverage to providers and / or pharmacy members.
• Read, interpreted, and entered information into the facility’s database using medical coding protocol to produce a medication request.
• Conducted various amounts of research, accessing several documents within policies to ensure quote and service accuracy.
• Performed other related duties as assigned
• Knowledgeable in the usage of standard MS Office products.
• Utilized proper phone etiquette with high call frequency.
• Operated standard office equipment; standard business computer hardware and software.
• Maintained business and professional relationships and ethics involved amongst hospitals, physicians, and patients
• Communicated clearly and concisely
• Worked well under pressure and adapted to changes in projects priorities.
• Ability to accommodate a flexible work schedule. Collection Agent
First Credit Services-Columbus, GA
July 2018 to June 2019
• Located customers with outstanding debts
• Reached out to customers by phone, email, mail, or in person to request payment
• Created payment plans or settlements that are favorable to the customer and the business
• Kept detailed records of all communications and actions
• Investigated discrepancies and answered customer questions about their accounts
• Ensured compliance with federal, state, and local laws Fraud Analyst
TSYS-Columbus-GA
August 2017 to April 2018
• Reviewed bank accounts, financial transactions, accounting paperwork, and other financial documents for anything suspicious
• Used data analysis, forensic accounting, and fraud examination to gather evidence and build cases against perpetrators
• Created strategies to prevent and mitigate fraud, such as new fraud detection security models
• Conducted complex investigations and acting as the subject matter expert on fraud prevention
• Carried out claims filing procedures in accordance with the organization's policies and applicable laws
• Trained new team members
Senior Assistant Manager
Security Finance /Patriot Loan Co-Hinesville, GA
June 2006 to August 2015
• Interviewed applicants to gather information and answer questions, and to assess their ability to repay the loan. I also research applicants' financial history, credit, and property evaluated.
• Explained the different types of loans and their terms, and advised clients on the risks and benefits of alternative lending options.
• Developed loan applications, obtained supporting documentation, and submitted complete loan packages for processing. Review loan agreements to ensure compliance with state and federal regulations.
• Approved loans within specified limits, and referred applications outside those limits to higher level management.
• Monitored borrower accounts, followed up on loan payments, and prepared statements for unpaid accounts. Negotiated repayment terms with customers and referred them to collectors.
• Ensured that loan files were accurate and complete. Reviewed and updated them regularly.
• Knowledgeable in accounts payable and receivable. Manager
Clyde's Market-Hinesville, GA
October 2004 to April 2006
• Ensured employees were properly trained, created work schedules, and recruited new staff.
• Counted inventory, ordered merchandise, and implemented promotions and discounts
• Ensured compliance with safety and environmental regulations, and the safety of customers
• Ensured employees provides excellent customer service and met customers' and company's needs
• Kept records of sales and profits, handling budgets, and making sure employees meet sales quotas.
• Maintained the cleanliness and appearance of the store, and conducted routine inspections and preventative maintenance.
• Handled unexpected issues that arose, such as equipment malfunctions or fuel shortages Education
Bachelor's degree in Music Production
LA School of Film - Los Angeles, CA
October 2024 to Present
Bachelor's degree in Business Administration
University of Colorado - Remote
January 2019 to June 2020
Associate's degree in Criminal Justice
Crown College - Tacoma, WA
January 1998 to July 1999
High school or equivalent in General
Ayer Highschool - Ayer, MA
August 1989 to June 1992
Skills
• Application Development
• Management
• Word
• Kitchen Management Experience
• Proofreading
• Medical Coding
• training
• Anatomy Knowledge
• Transcription
• ICD-10
• CPR
• Management (10+ years)
• Finance and Lending (10+ years)
• Multi-line Phone Systems
• Microsoft Word
• EMR Systems
• Medical Records
• Payroll
• HIPAA
• 10 key (10+ years)
• Medical Billing
• Financial Report Writing
• Microsoft Programs (10+ years)
• Accounting
• Clerical Experience
• Accounts Receivable
• Negotiation
• Insurance Verification
• Collections (10+ years)
• Organizational Skills
• Retail Management
• Contract Negotiation
• Medical Office Experience
• Medical Scheduling
• QuickBooks
• CPT Coding
• Medical Terminology
• Recruiting
• Cash Handling (10+ years)
• Customer Relations (10+ years)
• Phone Etiquette
• Microsoft Powerpoint
• Microsoft Outlook
• Relationship Management
Certifications and Licenses
Driver's License
October 2020 to October 2028
056232390 Georgia
Ga Work Ready
March 2000 to Present
CERT # XXHMXB8VKXM3
Tax Preparer
December 2011 to Present
Cert # -
D5689DLA8856HBMF958K6LB8A
GEORGIA INSURANCE LICENSE
October 2006 to October 2018
License # 764948
NPN 8880645
Assessments
Customer focus & orientation — Proficient
February 2024
Responding to customer situations with sensitivity Full results: Proficient
Protecting patient privacy — Proficient
August 2024
Understanding privacy rules and regulations associated with patient records Full results: Proficient
Time management skills — Proficient
August 2024
Managing one's own time to complete tasks quickly and efficiently Full results: Proficient
Attention to detail — Proficient
December 2023
Identifying differences in materials, following instructions, and detecting details among distracting information
Full results: Proficient
Project timeline management — Proficient
August 2024
Prioritizing and allocating time to effectively achieve project deliverables Full results: Proficient
Customer service — Proficient
February 2024
Identifying and resolving common customer issues
Full results: Proficient
Sales skills — Proficient
August 2024
Influencing and negotiating with customers
Full results: Proficient
Management & leadership skills: Impact & influence — Proficient August 2024
Choosing the most effective strategy to inspire and influence others to meet business objectives Full results: Proficient
Work style: Reliability — Proficient
December 2023
Tendency to be reliable, dependable, and act with integrity at work Full results: Proficient
Mechanical knowledge — Proficient
August 2024
Understanding and applying mechanical concepts and processes Full results: Proficient
Work style: Reliability — Proficient
August 2024
Tendency to be reliable, dependable, and accountable at work Full results: Proficient
Verbal communication — Proficient
September 2024
Speaking clearly, correctly, and concisely
Full results: Proficient
Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
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