Customer Service

SUMMARY

SKILLS

EXPERIENCE

MELISSA R MCKOY

Greensboro, NC 27406 C: 336-***-**** **********@*****.*** Business-minded professional tackling any job task with energy and precision. Determined Self-starter delivering exceptional service and responding to questions and inquiries quickly while demonstrating a positive attitude and the ability to adapt to any situation. Remarkable customer service providing superior level of customer service to external as well as internal customers. Proven ability to run front desk, keep customers satisfied and resolve any conflicts that may arise. Technically-savvy, friendly, punctual and always prepared for any challenge. Account verification and

reconciliation

Systems & Software enQuesta

proficiency

Recordkeeping

Team leadership

Problem solving

Accounting systems

Organized

MS Office

Exceptional customer service

Excellent communication skills

Patient relations

Healthcare coding competency

Knowledge of HIPAA regulations

Knowledge of medical

terminology

Medical billing

Water Utility billing

Data entry

Claims processing

Billing dispute resolution

Audit procedures

Interest calculations

Invoicing proficiency

Telephone etiquette

Issue resolution

Coaching and training

Conflict management

Listening skills

Public relations

Customer service orientation

Training and coaching

08/2016 to 12/2019 Sam Edit Claims Adjuster

UnitedHealth Group Remote

Obtained all necessary information to complete proper evaluation of medical claims.

Complied with company and insurance client's guidelines in claims processes, adjustment and closing of claims, resulting in proper claim payment.

Completed anual anti-fraud training courses.

Reviewed data to verify validity of claims.

Investigated potentially fraudulent claims with focus on thoroughness, quality and cost control.

Completed required investigations on referred files in timely manner. Participated in educational opportunities, including workshops, seminars and training classes to gain a stronger education in industry updates and federal regulations.

Assessed billing statements for correct diagnostic codes and identified problems with coding.

Reviewed all claims for accurateness and appropriateness. Researched and rectified account discrepancies.

Investigated denials and collaborated with internal team members and third-party representatives to identify solutions. Enforced compliance with organizational policies and federal requirements regarding confidentiality.

Reviewed account information to confirm patient and insurance information is accurate and complete.

Provided prompt and accurate processing through knowledge of government regulations, health benefits and healthcare terminology. Performed with precision by entering data accurately and researching to resolve questions.

Performed insurance verification, pre-certification and pre-authorization. Assessed medical codes on patient billings for proper payment. Added modifiers, coded narrative diagnosis and verified diagnoses. Applied HIPAA Privacy and Security Regulations while handling patient information.

Checked claims coding for accuracy with ICD-10 standards. 05/2006 to 08/2016 Billing Specialist

The City Of Greensboro/Water Resources Division Greensboro, NORTH CAROLINA

Eliminated inaccuracies in accounts receivable by verifying information prior to generating billing.

Generated over $84 million annual revenue for over 101,000 water/sewer accounts.

Eliminated billing inaccuracies by reconciling 100,000+ accounts monthly. Established, enforced and optimized billing policies and procedures to maximize revenue, streamline operations and minimize aging balances. Facilitated payment of invoices due by sending bill reminders and contacting clients.

Prepared year-end closing statements, financial documents, and invoices for audits.

Trained new team members on company policies and accounting systems to keep team operations productive and efficient.

Checked software programs for usability, functionality and design issues. Consulted with product owners and developers to fully understand intended features and functionality.

Documented defects and software problems in the System & Software enQuesta program.

Worked with off-site teams to complete timely tests and facilitate smooth product releases.

Documented identified defects and helped developers complete further testing and resolve issues.

Read and interpreted client requirements and design specifications to gain full understanding of each software program.

Recreated conditions submitted through client error logs to test performance under circumstances likely to reveal operating system compatibility issues and other desktop environment shortcomings. Collaborated with developers, system installers and technical support representatives in identifying errors to determine appropriate team to consult for resolving issue.

Liaised between clients and tax authorities such as the Guilford County Tax Department.

08/2002 to 05/2006 Supervisor

The City Of Greensboro Water Resources Division Greensboro, NORTH CAROLINA

Established and maintained operating schedules to provide effective coverage for key areas and to achieve customer service objectives. Addressed employee and production issues to determine and implement optimal resolutions, preventing wasted resources and maintaining schedules.

Designed training assessment and provided hands-on instruction to 8-10 employees to instruct employees in the role of Water Resources Representative.

Observed staff to determine resource needs.

Executed new training initiative to develop and improve skills for the City's Contact Center.

Trained newly hired employees on office equipment and created training materials for all Customer Service Reps to use as reference guide. Maintained high level of morale and team-work through frequent communication and relationship building with employees. Assisted in development of individualized lesson plans, goals and criteria for employees.

Established solid working relationships with peers, throughout various City departments through effective communication, openness and reliability. Coordinated with internal departments to maximize operational efficiency across production and administrative areas.

Interviewed applicants, recommended individuals for hiring and EDUCATION AND TRAINING

evaluated staff performance.

Realigned workflows with changing business demands by evaluating processes and employee strengths.

Supervised successful team of 8 Customer Service Representatives by conveying information consistently, quickly resolving issues and delivering constructive feedback.

Assessed employees' strengths and delegated tasks based upon expertise and knowledge, which increased employee morale and workflow. Identified and corrected performance and personnel issues negatively impacting team and business operations.

09/2001 to 08/2002 Customer Service Representative The City Of Greensboro Water Resources Division Greensboro, NORTH CAROLINA

Informed customers of procedures for applying for services. Compiled information regarding new accounts and entered information into computers and file related forms to establish water/sewer services. Maintained customer data confidentiality while inputting information into system using S&S enQuesta.

Alleviated issues quickly by getting in touch with customers and explaining steps for successful resolution.

Provided exemplary service to customers by utilizing such skills as effective listening and empathy.

Responded efficiently to customer queries and complaints to find solutions and diffuse tension.

Collected and recorded customer deposit and fees and issued receipts. Secured payments by following up with customers which disregarded promise to pay.

Fielded incoming phone calls from customers and directed to corresponding department or individual for assistance. Maintained extensive Rolodex of commercial and residential leasing agents.

06/1986 High School Diploma

Hugh M Cummings High School Burlington, NC

Some College (No Degree): Business Administration And Management North Carolina A & T State University Greensboro, NC

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