Customer Rep / Field Inspector
Resume:
Chandra Cotton
Customer Service Rep
Tampa, FL **610
**************@*****.***
I have an updated email of **************@*****.*** 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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