Chandra Cotton

Customer Service Rep

Tampa, FL **610

adw27p@r.postjobfree.com

+1-863-***-****

I have an updated email of adw27p@r.postjobfree.com and a background equiped with years of experience in customer service such as working from home, office settings and face-to-face. Mueller Reports provided me the necessary skills in performing property inspections. I completed inspections for State Farm and Citizens home owners insurance. I developed a keen eye for details as an Enrollment Specialist. Enrolled members for Medicare / Medicare Advantage Plans and Prescription Drug Plans. My experience includes verification of benefits through Marx, ACHA, CSNP and DSNP plans.

Willing to relocate: Anywhere

Authorized to work in the US for any employer

Work Experience

Property Inspector

Mueller Reports - Tampa, FL

May 2022 to August 2022

Completed home owner inspections for State Farm & Citizens Insurance Organized a daily schedule for inspections by location Contacted home owners to schedule inspection as requested in/out or both Meeting deadline for scheduled inspection

Identify roof types (3Tab Shingles), roof pitch (slope of 6-in-12) and age of roof (Hills. Co. Property Appraiser or any docs of roof repair)

Identify electric Manufacture (General Electric or Square D) Identify Heating source (Central Air/Condenser, space heater etc. & conditions) Identify Plumbing (Hot water heater (condition & shut off valve), piping (PVC /Copper) Identify crawl spaces or basements

Diagram basic square footage of home

Claims Rep. Customer Service

Continental Benefits - Tampa, FL

November 2017 to March 2021

• Processing claims using CMS 1500 forms to bill claims with health insurance providers.

• Processed claims using CPT codes and newest ICD codes and insurance coverage.

• Communicating with providers to assist with reconsideration on denied claim.

• Communicating with providers to clarify health insurance coverage based on dates of service and diagnosis codes.

• Verify Insurance coverage to assure that claims can be covered through Medicare/Medicaid. Resource Specialist

Career Source of Tampa Bay - Tampa, FL

November 2015 to August 2017

• Assist clients face-to-face with utilizing Employ Florida Marketplace to search for employment and Department of Economic Opportunity to claim unemployment

• Maintain strict confidentiality when exposed to sensitive information/issues Customer Service Representative

Medco/Acreedo - Tampa, FL

January 2014 to August 2015

• Received inbound calls from members/providers verifying enrollment and eligibility in mail order drug plan.

• Assisted providers with billing information information in regards to claims.

• Processed CMS 1500 claims with system calculations of copays (in/out network) and calculations of deductible (family/individual)

• Processed orders/reorders for members via USPS or FedEx including cold packed items.

• Per protocol track fulfillments per tracking number when fulfillments have been delayed.

• Verified EOB's and payments via credit card or banking thru Zelis payment portal. Special Population Coordinator / CSR

Well Care Health - Tampa, FL

August 2013 to December 2013

• Received inbound calls from perspective Well Care members in twelve states enrolling members in health/drug plans during Open Enrollment and Annual Enrollment.

• Verified member's Medicare and/or Medicaid eligibility/benefits status on health/drug plans (in/out network coverage), drug plans (coverage classifications/Tier status on medications), benefit type (HMO, PPO, EPO, SNP, PDP, Medicaid or/both Medicare)

Enrollment Specialist / CSR

Vangent - DGIT - Tampa, FL

September 2012 to May 2013

• Received inbound calls from Medicare members and enrolled members into a variety of Health Plans and Prescription Drug Plans.

• Knowledgeable in detail on enrollment and disenrollment requirements

• Knowledgeable and varied in processing rules based upon the product (HMO, PPO, EPO, SNP, PDP, etc.) Education

Certificate in Medical Assista

Concorde Career Institute-Tampa - Tampa, FL

January 2014 to February 2015

Associate's in 160 credit hours not defind

Hillsborough Community College - Tampa, FL

August 2006 to June 2010

Technical in Communications

Brewster Technical Center - Tampa, FL

January 1990 to February 1991

Diploma in Printing & Graphic Arts

Tampa Bay Voc. Tech High School - Tampa, FL

August 1985 to June 1988

Skills

• Developmental Disabilities Experience (10+ years)

• Special Needs (10+ years)

• Medical Records

• Writing Skills

• Medicare (3 years)

• Insurance verification (4 years)

• Customer service (10+ years)

• Microsoft Office (10+ years)

• Medical office experience (Less than 1 year)

• ICD Coding

• CPT Coding

• Citrix

• HIPAA

• ICD-10

• Medical terminology

• ICD-9

Assessments

Work style: Reliability — Highly Proficient

February 2021

Tendency to be dependable and come to work

Full results: Highly Proficient

Customer focus & orientation — Proficient

December 2021

Responding to customer situations with sensitivity Full results: Proficient

Work motivation — Proficient

July 2021

Level of motivation and discipline applied toward work Full results: Proficient

Medical receptionist skills — Familiar

January 2023

Managing physician schedules and maintaining accurate patient records Full results: Familiar

Customer service — Proficient

September 2021

Identifying and resolving common customer issues

Full results: Proficient

Protecting patient privacy — Proficient

January 2023

Understanding privacy rules and regulations associated with patient records Full results: Proficient

Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.

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