Courier/driver
Resume:
Kelley Coulon
**** ******** ** *****,** *****
*******@***.***
Professional Experience
Paradigm Specialty Surgical Network
Billing Specialist
• Run bills through Mitchell Smart Advisor to obtain bill review allowances.
• Interact and communicate with clients and providers through phone support, email, faxing, provider portals & mail communications.
• Apply client and provider contract pricing.
• Assist providers with questions related to provider contracts and claim/payment processing.
• QA on bills rec’d via EDI .
• Read, Interpret HCFA’s & UB’s
• Provide AP/AR support as needed.
Understand & comply with all HIPAA & SOC2 requirements necessary in working with designated PHI.
• Process reconsideration accounts
• Publix main billing contact
• Create TIN FLIP bills & mail to Publix
Amerigroup/Anthem Aug. 2015-Dec. 2016
Utilization Management Specialist (non clinical)
• Create shells for various providers for precertification of DME/HH/HI
• 40 a day Metrix
• Review each request for medical treatment.
• Attain positive and cooperative tone with providers and co-workers.
• Maintain production levels and quality goals.
• Assist providers with knowledge of the requirements to submit an authorization request.
• Gather clinical information regarding the cases that are pulled from the queue.
• Work independently and possess problem skills.
United Health Group Dec. 2014-Apr. 2015(contract)
Senior Customer Service Rep
• Serviced customers in Retiree Reimbursement Department & Exchanges Department(Obama Care)
• Delivered world class customer service.
• Attained positive and cooperative tone with customers and co-workers.
• Maintain production levels and quality goals.
• Assisted customers with knowledge regarding their accts for RRA &Exchanges
• Assist customers with billing inquires
• Accept payments
• Work independently and possess problem skills
Terminix Jan. 2013 – May 2013(Contract)
Customer Service Representative
• Delivered world class customer service and build customer satisfaction and loyalty.
• Provided effective and timely resolution of a range of customer inquiries.
• Submitted customer requests that generated work orders to technicians.
• Scheduled service calls.
• Strived for one-call resolution of customer issues.
• Completed ongoing training to stay abreast of product, service and policy changes.
• Processed customer credit/debits, provided invoicing information and monitored rebates
• Attained a positive and cooperative tone with both customers and coworkers.
• Demonstrate best judgment in the disbursement of adjustments and credits.
• Increase the customer experience by providing information on new products, rate plans, and services through up selling opportunities.
Vangent (Medicare) Jun. 2012 – Jan 2013 (Contract)
Customer Service Representative
• Delivered world class customer service and build customer satisfaction and loyalty.
• Provided effective and timely resolution of a range of customer inquiries.
• Strived for one-call resolution of beneficiary issues.
• Completed ongoing training to stay abreast services and policy changes.
• Assisted beneficiaries with picking drug plans
• Provided beneficiaries with info regarding their part A/B medical claims
• Attained a positive and cooperative tone with both beneficiaries and coworkers.
• Took a range of 100-180 calls per day.
Education
Thomas Jefferson High School – High School Diploma
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