Data Entry Customer Service
Resume:
Claudette Doyley
Miami, FL 33161
(P) 786-***-****
***************@*****.***
Skills
●Types 45-50 WPM
●Data Entry 8,000 KPH Alpha/Numeric
●Customer Service Oriented
●Microsoft Office, Word, Excel / Windows Proficient
●Claims Support/Data Entry
●Medical Insurance Verification
●CMS 1500 Knowledge
●Call Center Experience
●Accounting Payable/ Receivable support
●Written Comprehension
●Familiar with HIPAA compliances
Work Experience
01/19 – 07/2019 Global Management Medical Pembroke Pines, FL
(Assistant Coordinator)
●Customer Service, Email Correspondence, respond to member and provider in timely manner.
●Assist Member and Provider with the Letter of Guarantee of Benefits, verify member’s benefits to covered medical expense
●Utilizing the VCC application, FEPBlue 360 application, Claims retrieval
●Assist member with claims verification and claims research validation of payment
●Utilizing the VCC application, FEPBlue 360 application, Claims retrieval
● Data processing of Member database in the VCC application system
●Upload Member’s Medical Information, and personal data needed for Claims and medical decision making for the Medical Team Staff and Claims
●Followed state’s compliance rules and HIPAA guidelines
8/2018- 10/2018 Mindlance Agency Philadelphia, PA
(Provider Maintenance Technician /Data Entry)
● Assisted Credentialing verify provider’s data
● Utilizing CAQH, NPI, Medicaid, Facility, DEA applications
● Data processing of provider’s data Macess System
● File maintenance and utilizing Excel reports for track of file maintenance
● Assist with Facility & Provider utilizing Facets App
● Assist with Outlook inbox request, followed state’s compliance rules and HIPAA guidelines
● Uploaded correspondences, license, education verification, utilizing Adobe app.
06/2017- 04/2018 Health Care Support Maitland, FL
(Program Coordinator / Data Processor)
●Assisted with Member’s enrollment
●Analyzed and updated members’ demographic information in database
●Followed state’s compliance rules and HIPPA guidelines
●Scanned and uploaded members requested information as needed
●Verified members’ benefit coverage
●Updated members’ accounts with registration, scheduling, and billing data
●Maintain time management for State Guide Compliance regarding member’s database
●Followed state’s compliance rules and HIPAA guidelines
01/2016- -06-2017 Career X Change Pembroke Pines, FL
(Data Processor/ Administrative Support)
●Entered data into system via online terminals and other data entry devices
●Verified entered data for accuracy and completeness
●Prepared and coded data for entry into system
●Investigated and reconciled any discrepancies in files
●Assisted customers and employees by telephone and in person
●Furnished requested information in a timely manner
02/2004- 10/2015 Emblem Health Administrators Hollywood, FL
(Data Processor)
●Validated codes for CSM 1500 forms
●Provided data collection and report development support
●Maintained patient files
●Provided records as requested by providers and administrative staff
●Prepared monthly reports as assigned
●Assisted validating claim liability and claim status
●Process patient referrals for services
●Verify contracted provider information
●Performed other administrative and clerical tasks as needed
●Referral Processing
●Followed state’s compliance rules and HIPAA guidelines
Education
Miami Killian High School High School Diploma Miami, FL
Robert Morgan Technical Institute Data Processor Certification Miami, FL
Miami-Dade College Computer Science Miami, FL
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