Customer Service Representative

Tishea Glover

**** ******** *** ********, ** ****9* adw93a@r.postjobfree.com* 614-***-****

EDUCATION

Columbus Alternative High School Diploma

Kaplan University

Medical Billing and Coding Certificate

RELEVANT EXPERIENCE

Graduated June 2 Columbus, Ohio003

Columbus, Ohio

Completed July 2011

Policy Processing Department

Account Examiner II

State of Ohio

Columbus, Ohio

April 2013- Present

●Respond to written and telephone inquiries from both public and private employers

●Monitors, review and establish coverage for business accounts

●Audit employer accounts according to O.R.C Section 4123.01 adhering to the effective date

●Process True-Up reports and amended True-Up reports

●Examine and process payroll

●Updates demographic records for employers

●Makes needed financial adjustments and examines accounts for needed credits due to cancellations

●Refers non-complying employers for review and identifies audit ad complaints to appropriate area for review ● Types correspondences and reports as needed

●Gathers proper documentation for preparation as needed

Bureau of Workers Compensation

BWC Customer Service Representative

State of Ohio

Columbus, Ohio

January 2012- April 2013

●Provided information and assistance to customers regarding coverage

●Resolved customer complaints and inquiries via telephone and in writing regarding claim status and payments

●Provide technical assistance concerning use and navigation of ohiobwc.com

●Explain policies and procedures to customers and employers

●Explain financial adjustments or balances owed and refunds

●Operate personal computer to file claims for customers in claim tracking system ● Update existing customer information

Aetna New Albany, Ohio

Provider Customer Service Representative April 2009- December 2011

●Respond to provider calls from hospitals, doctor offices, nursing facilities and laboratories regarding claims and benefits

●Assist providers with claim processing information, discrepancies and adjustments

●Refer needed claims over for review and assist providers with needed information regarding prior authorization for procedures for patients

RELATED SKILLS

Computer Skills: Proficient in Microsoft Office, Outlook

General Skills: Communication, time management, conflict resolution, adaptable

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