Medical Billing Claims Representative

CARLA

MACK

470-***-****, *************@*****.***

PROFESSIONAL SUMMARY

Results-driven sales team member with strong retail background. Relate well to customers of different backgrounds, promoting products and driving sales. Prevent thefts by consistently monitoring entrances and sales floor for suspicious behavior.

Reliable candidate ready to take on challenges in a position using problem-solving and task prioritization skills to help team succeed.

Dependable employee seeking opportunity to expand skills and contribute to company success. Considered hardworking, ethical, and detail-oriented.

Stays on top of demands in fast-paced environments by effectively using slow periods. Maintains organized, clean and safe work areas with diligent attention to important details. SKILLS

Written communicationTime managementTask prioritization CoordinationClaims supportBilling resolution

Claims preparationCoverage determinationPolicy review Microsoft WordAnalytical thinking

EXPERIENCE

Customer Service May 2020 - July 2021

Nationwide Property Investments LLC Atlanta, GA

Captured consistent customer sales with friendly, knowledgeable support. Promoted products effectively by staying on top of offerings and prices. Overcame customer objections using powerful product demonstrations. Met sales quotas, frequently exceeding targets by taking advantage of upselling opportunities. Maintained customer satisfaction, quickly resolving issues and offering expert assistance. Assisted customers with sales and service needs.

Maintained full compliance with legal, health, and safety regulations. Collaborated with team members to meet daily demands and handle challenging projects. Customer Service Representative January 2012 - September 2019 AT&T Atlanta, Ga

Followed up with customers to offer additional support and check resolution satisfaction. Managed customer calls efficiently in a fast-paced call center environment. Delivered fast and friendly service regarding questions and service complaints. Assisted customers in resolving product problems regarding usage or repair. Documented, researched, and resolved customer service issues. Maintained customer satisfaction by addressing customer needs and resolving concerns. Contributed to billing accuracy by determining charges for services requested, collecting deposits, and arranging long- term payment plans.

Claims Representative

March 2000 - December 2004

Blue Cross Blue Shield Atlanta,Ga

Conducted inspections and interviews with claimants and policyholders. Documented claim file activities in [Software].

Demonstrated commitment to company conduct, ethics, and compliance policies and procedures and adhered to all state and federal regulations.

Investigated claims of varying complexity and obtained relevant facts to determine coverage and liability. Adhered to all claims processing policies and procedures, grievance procedures, state mandates, and benefit plan documents to address claims.

Examined policy coverage forms and other records to determine insurance coverage. Helped with processing by preparing accurate insurance claims forms and related documentation. Updated databases with new information from newly filed and open insurance claims. EDUCATION

High School Dipolma May 1994 Andrew Jackson High, Jacksonville, Florida Associates April 2000

Ultra Sound Diagnotics School, Jacksonville, FL

Medical Billing and Coding Claims

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