Customer Service Data Entry

GINA R. HOOVER

**** ********* **. *** ****, Folsom CA. 95630 530-***-**** adx7b1@r.postjobfree.com

Objective

Seeking a position that will benefit from my customer service experience, and positive interaction skills. Where my experience can improve the customer satisfaction. Experience

CUSTOMER SERVICE LUCENT HEALTH SOLUTIONS LLC AUGUST 2016-MAY 2023

· Research policies and quoted benefits to providers and members.

· Answers phone calls utilizing effictive interpersonal and communication skills.

· References internal and external systems to obtain claim and eligibility information

· Successfully complete task and data entry for department within reasonable time frames and fax and email members and providers detail information while complying with HIPPA regulations.

· Maintains and enters notes with details and accuracy on call log application. CLAIMS EXAMINER HEALTH NET FEDERAL SERVICES MARCH 2014-JULY 2016

· Utilization knowledge of CPT procedure codes, ICD-9, ICD-10 diagnosis codes while maintaining productivity requirements.

· Researching plan details to determine Veterans claim eligibility while following adjudication policies and procedures.

· Handle special projects as assigned by Supervisors and Management CLIENT SERVICE REPRESENTATIVE TCS, Inc.- MAXIMUS MARCH 2013-MARCH 2014

· Evaluated data to determine beneficiary’s current CRM enrollment status.

· Knowledge of enrollment CRM status codes and action types.

· Processed disenrollment, closed disenrollment fees for service and plan changes.

· Provided callers with Covered California Health Benefit Exchange using the MAXe2 program. Page 2

Education

Carrington College California, Sacramento, CA

Medical Billing and Coding Certificate Program, Certificate Napa Valley College, Napa, CA.

Associates Degree (General Education)

· CPT/ICD-9&10 Coding

· Medical and Dental Billing

· Insurance Verifications

· UB04 Claim Forms

· Claims Processing

· HIPAA Compliance

· Basic Office Skills

REFERENCES AVAILABLE UPON REQUEST

s

· Medical and Dental Terminology

· CMS1500 Claim Forms

· Communication Techniques

· Data Entry

· EOB Interpretation

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