Medical Billing Customer Service
Resume:
Sheena Taylor-Frazier
Chickasaw, Alabama 36611
****************@*****.***
My objective is to obtain a full-time position with a growing and forward thinking company. I am reliable, hardworking with expertise in customer service, complaint handling/resolution, and customer relations. I have exceptional organization skills with strong attention to details
SKILLS
*Customer Service Skills *Computer proficiency *Certified in 10-key
*Type 50 WPM *Leadership experience *Communication skills
*Fast Learner *Hard Working *Efficient problem solver
*Results-oriented *Accurate Data Capture
EXPERIENCE
Molina Healthcare Provider Services/Claim Representative Virtual
03/2020-02/2022
●Answered inbound provider calls nationwide for subscribers of Molina Healthcare in NY, MS, CA, IL, OH medical insurance plans.
● Answered inbound calls from hospitals, medical practices and substance abuse/mental health facilities to answer medical policy insurance inquiries.
●Provided up to date benefit quotes stating copay, deductible, coinsurance, and out of pocket values for specific medical procedures.
●Researched cpt codes for various medical procedures giving the accurate benefit quote and supporting medical policies that may influence medical claim approval.
● Reviewed medical policy bulletins if applicable for providers with claim denials.
●Reviewed and submitted adjustments when claim denial errors are discovered.
● Explained provider offsets/refunds to providers when payments are recouped for claims paid in error
CVS Pharmacy Benefit Verified Representative Virtual
10/2018-03/2020
●Answer inbound calls from pharmacists and staff regarding denied claims and checking eligibility.
●Assisted member with issue of filling medication at pharmacy.
●Assisted member with new order and refill through mail order
●Assisted member with issue of not receiving or over charge of mail order
●Assisted member with check coverage and cost of medication
●Sent request to providers for medication refills
Conduent, Inc Tech Support/Senior Support Virtual
04/2016-10/2018
●Answering inbound calls assisting with iOS/macOS technical issues regarding their apple devices
●Assisted customer with starting and managing apple id accounts
●Assisted member with locked or lost devices
●Managed high call volume with tact and professionalism
●Handle escalated calls and provided senior support to tier 1 representatives
Auto Injury Solution Data Entry/ISL Claim Processor Daphne,Al
01/2013-04/2016
●Process over 25 auto claims daily and data captured over a 800 line daily.
●Organized medical billing/invoice data, data captured all charges and prepared accounts for adjuster.
●Contacted customers to give and receive missing documents for claim to be processed
● Made outbound calls regarding insurance verification or inquiries regarding billing codes for medical providers
EDUCATION
Satsuma High School Satsuma, Alabama - HS Diploma
08/2000- 05/2004
Remington College Mobile, Alabama - Medical Assistant/Billing Certification
04/2005-09/2006
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