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Customer Service Fraud Investigator

Location:
Princeton, NC
Salary:
$25.00
Posted:
January 22, 2023

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Resume:

Takisha Gathers

*** ******* ******

Princeton, NC 27569

919-***-****

OBJECTIVE: To work in an agency for advancement, to accomplish goals and to excel in the work environment as a motivated team player. Also I want to make a difference in any place I work and bring on a great attitude and a very good work ethic. I am dedicated to my work and do not mind helping others. I will make a great candidate for the job.

EXPERIENCE:

UNC REX NCHV Smithfield,NC ARR Scheduler/Coordinator 2021-Present

Schedule appointments for 7 locations, process workques, daily and weekly no show report

Process referrals to the designated facilities, answer incoming calls for Heart and Vascular

Johnston County Clerk of Court Smithfield, NC

Deputy Clerk 2020-2021

●Document judgments in the courtroom, help citizens with questions about legal processes and enter data about court cases and outcomes

●File legal forms and files, case file indexing and an assortment of other tasks

●Provide strong customer service and assistance on a daily basis

UNC Johnston Health Smithfield, NC

Patient Access Team Leader 2014-2019

●Provided customer service support to patients, assisted patients with questions and concerns, lead the front desk medical administrative assistants in covering lunches and inputted data into the EPIC system

●Completed referrals for the providers that were located in the Work Que’s, scheduled appointments for patients, verified insurances with insurance companies and worker’s compensation and logged all self-pay patients into system

●Completed presentations quarterly during meetings with registration department on the MDI board, record keeping daily and monthly deposits, provided reports to supervisor on complaints concerning insurance billing and kept track of employee’s PDO and requests

Johnston County DSS Smithfield, NC

Caseworker II 2005-2014

●Responsible for reviewing and processing Medicaid, Medicare, Food and Nutrition, and Crisis applications and reviews.

●Answered complaints from applicants concerning denials, interviewed applicants to determine eligibility for programs and investigated fraud cases and writing up reports to send to the Fraud Investigator.

●Communicated with insurance companies and child support agencies from different states and processed wage verifications from employers.

●Provided customer service support to managers and associates within the department.

Education:

South Johnston High School 1993 Graduate Benson, NC

Sherrill’s University (Cosmetology) 2014 Graduate Raleigh, NC

JCC (Medical Office Technology) Smithfield, NC



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