Customer Service Medical
Resume:
denise haddon
Westbrook, ME *****
******.********@*****.***
Work Experience
Front Line Customer Service
LogistiCare - South Portland, ME
February 2017 to Present
• Front end customer service environment that assists health care programs provide transportation for their members
• Entered electronic reservations over the phone and applying the members contractual benefits to each trip
• Fast paced front line customer service environment with multiple phone lines and a high call volume
• Calls taken while researching and accessing the level of transportation needed
• Other duties assigned as needed
Customer Service Representative/Call Center
Sirona Health - South Portland, ME
July 2015 to February 2017
• Customer service environment and answering service
• After hour calls for medical professionals that included triaging and making sound medical decisions to prepare patient information
• Other types of calls included quoting multiple insurance companies benefits
• Took physician on call messages
• Patient calls including facility information and class registrations
• Physician Referrals
• Other duties as assigned
Claims Processor II
Anthem, Inc. - South Portland, ME
April 1997 to April 2015
• Experience in multiple levels of customer service and claims processing including but not limited to medical, hospital, skilled nursing claims for subscribers and providers
• Detail-oriented with strong analytical and investigative skills.
• Extensive knowledge in reading and working with insurance contracts and benefits.including ME Care and Medicare
• Adjusting claims with off sets and tertiary insurance for members and providers
• Reading and assigning medical records to correct medical review members
• Sending requests for medical records and or insurance information for adjustments and claim processing
• worked with blocks of claims with deadlines
• Manual priced coinsurance and deductibles according to the insurance contract and accrued benefits accordingly
Education
Associate in Business
Quinnipiac Community College - New Haven, CT
September 1982 to May 1985
Skills
• Data Entry
• Health Insurance
• Medical Terminology
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