Latonia

Williams

Latonia williams

**** ******* **.

Jurupa Valley, Ca 92509

951-***-****

adw7f3@r.postjobfree.com

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Skills

Customer service which involved answering calls from providers as well patients. Handling customer inquiries and complaints. Document and update customer records based on interactions. My objective is to be involved in work where I can utilize my skills and creatively evolve with a system that effectively contributes to growth of the organization. To find a company that would like a hard worker not afraid to take on a challenge I am a self-starter and I work well with others, also a quick learner with the ability to adapt to change.

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Experience

Epic Management

Claims Examiner

Sept 2012 to Dec 2018

Determine if the policy of the insured covered the loss claimed. Strong customer service as well as communication, and computer skills. Talked to providers to ensure that any questions or concerns that they may have is answered so they can gain complete understanding of the claim or issues that may be in question. Always followed HIPPA guidelines, reviewed complex claims as an extra set of eyes to assist the claims adjuster and check on the case regularly to ensure proper guidelines were followed. Detailed all conversations and filed periodic reports for review by claims manager. Obtained the physician statements and relevant medical records often limiting the company's liability. Primed Healthcare Administrators

Feb 2006 to Sept 2012

Claims Examiner

Processed electronic and paper medical claims within established guidelines in compliance and EZ CAP system. Would you located claims for adjustments under payments, as needed from customer service inquiries. Familiar with healthcare contracts, able to read and interpret dorf’s in conjunction with pricing claims, understand CPT codes, ICD-9, and HCFA 1500 claim form. The Milyer with all aspects of managed care field.

Target Corporation

Jan 2003 to Feb 2005

Department Supervisor

Duties include overseeing the department, scheduling training of new hires, assist with problems to resolve them. In addition encourage and motivate staff to be team players.

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Education

Eisenhower High School

Jun 26, 1983

High School Diploma

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