Service Representative Customer
Resume:
Diane M. Logsdon
Gladwin, MI 48624
Phone 989-***-****
Email ***********@*****.***
I am seeking part-time employment with a business that will allow me to work in an office setting.
Skills and Experience
Team Leader for a major health insurance company. Duties included hiring, training, and developing new employees; supervising established staff members.
Hearing Officer (for the same company as above). Duties included reviewing member and provider appeals submitted due to denied claims and benefits; conducting conferences directly with the members and providers regarding their appeals; making a final decision to maintain or overturn the denial of the appeal.
Customer Service Representative (for the same company). Duties included handling incoming telephone calls from members and providers concerning membership, claims, and benefit questions and concerns.
Claims Adjudicator (for the same company). Duties included reviewing and resolving claims that were stopped in the processing system due to the need for additional information.
Strengths
Excellent written and oral communication skills
Business planning and problem solving
Medical terminology
Familiar with HIPAA, Coordination of Benefits, Preauthorization, Preferred Provider Organizations (PPO)
Employment History
May 2016 to current - Employed at Walmart in West Branch, MI.
September 1984 to December 2014 (retired) - Blue Cross Blue Shield of Michigan
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