Customer Service Time Accounting
Resume:
Janet Carter
Mabelvale, AR 72103 ***********@****.***
Summary of Qualifications
Arkansas Resident Adjuster License #297090 – Casualty and Property
Solid management skills, demonstrated proficiency in leading and mentoring individuals to maximize levels of productivity, while forming cohesive team environments.
Analytical thinker that consistently resolves ongoing issues or defects.
Creates and maintains a climate of continuous improvement.
Supervising, motivating and developing personnel Technical Expertise
Software Amysis, PowerPoint, Excel, Workday, Microsoft Office 2003/2010, Lotus Notes R5, Oracle Financials, Oracle Discoverer Plus, Peachtree Accounting, TIME Accounting Systems AS400, TPX/Mainframe, most Windows-based systems Hardware Most personal computers, general office peripherals Typing 50WPM, 10-key by touch
Professional Experience
Arkansas Blue Cross Blue Shield
Claims Supervisor – BlueAdvantage National Accounts (September 2013-September 2022) Claims processing functions within the Wal-Mart Service Team. Responsible for supervising a team of Claims Specialists within the Wal-Mart Service Team. Demonstrated ability to motivate staff. Demonstrated ability to work through conflicts. Demonstrated ability to mentor/coach team members. Ensure timely and accurate claims processing, Exceeding performance expectations for our customers. Arkansas Blue Cross Blue Shield
Team Leader ITS/PreX/UR Claims and Special Processing (June 2010 – September 2013) Assist in developing and maintaining staff of Claims Specialists to process claims accurately, timely and efficiently. Maintain excellent working relationship with all departments that support customer service. Maintain a positive and productive work environment. Provide effective feedback and coaching regarding performance and quality standards. Mentor team members to ensure their understanding of work processes and expectations. Answer customer related inquiries and perform claim processing. Assist in testing system enhancements. Track inventory and ensure aged claims are processed with highest priority. Manage special inventories and assignments. Arkansas Blue Cross Blue Shield
Claims Specialist (January 2010 - June 2010)
Responsible for processing health insurance claims in an accurate and timely manner in order to meet government, corporate and national standards. Maintained acceptable performance levels based on established department standards for production and quality. Reviewed and interpreted contract benefits and edited/audited resolutions and claim payments. Generated correspondence and completed forms to obtain information necessary for claims adjudication. Reviewed correspondence in order to determine benefit eligibility. Maintained up-to-date knowledge on continually changing procedures, system modifications, medical terminology and contract benefits. Claims Management Inc (Wal-Mart Inc)
General Liability/Property Case Manager (February 2006 – July 2008) Responsible for verifying completion of claim forms. Calculated amount of claims and submissions for payment. Reviewed claims, initiated necessary investigations, and recommended action to be taken on the claim. Authorized payment of claims and established reserves. Worked with high accident stores to lower number of customer accidents.
Transplace
AR/Collections (November 2004 – February 2006)
Managed collections on 5 large accounts: Weyerhaeuser, Frito-Lay, WW Grainger, TruServ, Circuit City. Reduced receivables of one company by $100,000.00 in less than 6 months. Established and maintained relationships with customers and Operations department. Validated billing and created corrective entries. Created Discoverer Queries for extracting archived data.
• Employee of the Month 6 months into job
Education
Graduated Wilbur D. Mills High School 1992
Cadence Project Management 1992
State of Arkansas Insurance Department 2009 – Casualty and Property Adjuster Franklin Covey Project Management Essentials 2014
Contact this candidate