CYNTARVIA CLAYTON-WILLIAMS

***** ****** ***** **, ************, FL PHONE: 904-***-**** E-MAIL: adtu4d@r.postjobfree.com OBJECTIVE:

Seeking a position where my knowledge, skills, abilities acquired with over ten years of experience as a leading Medicare Associate and Customer Service Representative will be utilized to advance organization’s productivity and competitive edge in the industry. Capable of working with minimal supervision while adhering to medical policy guidelines and procedure due to medical necessity for payments and/or denials. Able to use multi-skills for daily tasks. EXPERIENCE:

8/2019 - Current ITech Resources

Cold Storage Processor

• Consistently met or exceeded production goals

• Packaging fresh food

• Box Marker

• Labeling boxes

06/2018-8/2019 Staff Zone Staffing Jacksonville, FL General Labor

• Responsible for timely pulling orders

• Consistently met or exceeded production goals

08/2017-04/2018 San Mar Jacksonville, FL

Tee-Shirt Processor

• Receivable consumer order/pick list

• Analytical customer order selection with preparation of shipping orders for accuracy

• Oversee inventory for minimal damage to packaging & distribution

• Assist management with additional project assignment as needed 12/12/2016 -- 02/13/2017 Imcomm (under contract) Jacksonville, FL CUSTOMER SERVICE ASSOCIATE

• Assisted consumers with inbound card inquires

• Processed Fraud watch tickets

• Processed replacement cards

• Handled financial disputes

10/2016 -- 12/2016 (Seasonal) Lyneer Staffing (Suddath Warehouse) Jacksonville, FL QUALITY CONTROL TEAM LEAD

• Verification of requested merchandise quality

• Assisted frontline staff with proper quality completion of daily work * Performed duties as a Cherry Picker in shipping and receiving

02/2016 -- 05/2016 AmeriHealth Caritas Jacksonville, FL CUSTOMER SERVICE ASSOCIATE

• Handled Inbound Medical Physicians calls

• Processed Data Entry inquires

• Changed Primary Care Physicians as requested

• Communicated with external customers and providers for claims processing 2004 -- 2015 First Coast Service Options (BCBSFL) Jacksonville, FL MEDICARE ASSOCIATE TELEWORKER

• Navigations for Medicare Part B claim related issues

• Assisted with determination of medical necessity

• Demonstrated proficient written communication with providers and beneficiaries

• Adjudicated claims for audits and suspension processing

• Identified fraud, aberrances, and abuse of Medicare policies and procedures

• Completed Analytical training and development

• Communicated with management daily in written communications for system outages EDUCATION:

Englewood Senior High School Jacksonville, FL – High School Diploma 1995 EXPERIENCE:

• Microsoft Office (Word, Excel, Outlook)

• Multi-Carrier System (MCS)

• Quality Management (QMS)

• Medicare Appeals Processing System (MAPS/CAS)

• REFERENCES:

• References are available on request

Contact this candidate