CSR
Resume:
Trina Turner
CSR/Medical Claims Processing
Selma, CA 93662
adtr9e@r.postjobfree.com
CSR
Handling incoming and outgoing calls to insure customer satisfaction. Motivated leader with strong
organizational and prioritization abilities.
Authorized to work in the US for any employer
Work Experience
Receptionist/Office Assistant
Billups cleaning - Selma, CA
April 2022 to Present
Scheduling appointments
Consulting
Contracts
Selling and upgrading contract jobs
Answering calls
Cleaning Residential homes
Medical Claims Examiner
Reqroute,Inc/BCBS
October 2021 to March 2022
Remote
Processed medical claims.
Reviewed and corrected code edits to allow or deny a claim. Reviewed prior authorizations and or requested authorizations. Customer Service Representative
HealthComp Administrators - Fresno, CA
February 2019 to September 2021
Work remote
Receiving incoming calls from providers and members helping them to resolve issues on claims eligibility and benefits for medical plans
• resolve issues on incorrect processing of medical claims
• issue tickets for adjustments on medical claims
• Verifying eligibility and benefits
• problem solving to make sure providers and members issues are resolved
• Assisted customers with a warm and professional attitude
• Assisted customers with questions
• Interacted with customers through live chat
• Kept records of customer complaints
• Handled emails, inbound calls, and outbound calls
• Managed customer accounts
• Monitored claims and physician-related services
• Assisted with technical support duties
• Handled billing issues and order inquiries
• Handled emails, inbound calls, and outbound calls
• Assisted customers with a warm and professional attitude
• Assisted customers with questions
• Interacted with customers through live chat
• Kept records of customer complaints
• Processed customer transactions
• Managed customer accounts
• Performed data entry for customer information
Claims Processor
Western Growers/ Aerotek - Fresno, CA
July 2018 to January 2019
Examine and process medical, dental, vision claims including: physician claims, re-pricing claims, emergency room, outpatient lab and x-ray, accident and Third Party Liability (TPL) claims, Medicare Secondary Payer (MSP) and surgery claims.
Review insurance policy to determine coverage. Prepare insurance claim forms or related documents and review them for completeness so as to finalize. Gather correct information so as to proceeding with claims processing on Workman's Comp and auto insurance facilities or local contractors. Post or attach information to claim file so as referrals precertification and authorization. Finalize medical claims. Transmit claims for payment or further investigation. Contact insured or other involved persons to obtain missing information. Request medical records to review and determine for medical necessity. Review COB's Request and review EOB's to determine primary pay and process to secondary insurance. Research and complete all correspondence related to all electronic and paper claims assigned Calculate allowed amount, refunds, adjustments and write off requirements, using insurance rate standards
Cashier/Customer Service
Marathon Gas Station - Maryville, TN
January 2012 to January 2015
Cashier
End of shift reports
Inventory
Stocking
Sales
Cashier/Customer Service/Sales Associate
Aztex Gas Station - Maryville, TN
January 2009 to January 2012
Cashier
End day reports
Stocking
Inventory
Training
Sales
Education
High school diploma in Business and Computers
Kiamichi Technology Center - McAlester, OK
June 1983
Skills
• Microsoft office (10+ years)
• Customer Service (10+ years)
• Typing (10+ years)
• computers knowledge (10+ years)
• computers (10+ years)
• Data Entry (10+ years)
• Medical Billing (2 years)
• Medical Terminology (2 years)
• Medical Records (4 years)
• Accounts Payable (5 years)
• Accounts Receivable (5 years)
• Collections (10+ years)
• Administrative Assistant (2 years)
• HCPCS
• Icd-10
• Health Insurance
• Hcfa
• ICD-9
• Medical Scheduling
• Records Management
• Microsoft Outlook
• Medical Imaging
• Transcription
• Medical Office Experience
• Insurance Verification
• Anatomy Knowledge
• Autism Experience
• Applied Behavior Analysis
• Physiology Knowledge
• Adult Education
• Clerical Experience
• Phone Etiquette
• Special Education
• Office experience
• Administrative experience
• Office Management
• Documentation review
• HIPAA
• Epic
• Microsoft Excel
• Medicare
• EMR systems
• Analysis skills
• Communication skills
Awards
Bronze and Gold metal in Typing
June 1982
60 wpm with no mistakes
Certifications and Licenses
CNA
August 1982
CNA nursing
Business and Computers
June 1983
Assessments
Medical Billing — Expert
May 2020
Understanding the procedures and forms used for medical billing. Full results: Expert
Customer Focus & Orientation — Highly Proficient
May 2020
Responding to customer situations with sensitivity Full results: Highly Proficient
Electronic health records: Best practices — Highly Proficient February 2021
Knowledge of EHR data, associated privacy regulations, and best practices for EHR use Full results: Highly Proficient
Medical billing — Proficient
December 2020
Understanding the procedures and forms used for medical billing Full results: Proficient
Data entry: Accuracy — Highly Proficient
February 2021
Entering data quickly and accurately
Full results: Highly Proficient
Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.
Additional Information
Skills
Critical Thinking
Time Management
Complex Problem Solving
Judgment and Decision Making
Monitoring
Systems Analysist
Production and Processing
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