Customer Service Data Entry

Myra Crenshaw

Indianapolis, Indiana

********@*****.***

Resume

SKILLS

Excellent communication and customer service skills Proficient use of computer, including: Microsoft programs, Internet Explore, Xerox copier, Fax machines

Outlook, Skype

Excellent multi-tasking skills

Ability to key 10,000 kph

Ability to type 60 wpm.

Knowledge of ICD-9 codes, CPT codes, Revenue Codes regarding health claim processing Knowledge of Supplemental Health Insurance and Life Insurance EXPERIENCE

Anthem BCBS; Indianapolis IN - November 2018 – present Full Time; 40hrs per week

Customer Service Associate I

Primary duties may include, but are not limited to; understands and communicates the benefit design packages to members as defined by employer. Interacts with members verbally and in written form to ensure appropriate engagements achieved.

Interprets plan benefit design, resolves claim, benefit, and enrollment issues while making a connection during the contact.

Assist in increasing member's engagement into appropriate programs and offerings. Acts as trusted advisor and educator on health care related inquiries. Customer Service Rep II

Primary duties may include:

Understands and communicates the benefit design packages to members as defined by employer.

Interacts with members verbally and in written form to ensure appropriate engagement is achieved.

Interprets plan benefit design, resolves claim, benefit, and enrollment issues while making a connection during the contact.

Assist in increasing member's engagement into appropriate programs and offerings. Acts as trusted advisor and educator on health care related inquiries. Knowledge of various system: Nasco GUI/mainframe, Solution Central; Actwise CDH and various support systems

CorVel - Pinnacle Partners Staffing

Worker's Compensation Insurance; Carmel, IN - August 2018 – October 2018 Full-time; 40 hrs per week

Intake Customer Service Representative

Primary duties include:

Managing a high volume of inbound calls

Entering orders received by email, fax and from the web for physical therapy, Occupational therapy, radiology services, transportation services Gathering information from patient, employer or attorney for data entry into company database assist with appointment scheduling

Responding to voice mails

Reviewing claims and respond to claim denials

CNO Financial Group; Washington National Specified Diseased/Supplemental Health Insurance Carmel, IN - October 2016 - July 2018

Full-time 40hrs per week

Claims Adjuster Specialist

Primary duties include:

Process claims for Accident and Cancer policies

Validate insured eligibility

Validate all required documentation received and policy requirements are met. Correspond with customer via letter or phone call

Correspond with health providers via letter or phone call Data entry of claim data for adjudication of eligible and non -eligible benefits Health Customer Service Representative - June 2015 – October 2016 Primary duties include:

Professionally answering inbound phone calls from our valued customers or agents. Provide claim services and support in a manner that promotes integrity and customer satisfaction.

Verifying information received (missing claim requirements, EOB, correspondence writing, mailing, e-mailing, faxing and customer call backs). Knowledge of various systems including Content Navigator, TPX – SINQ/SHARP/RESPOND, LIFEPro, Policy specimen Library, AIW

Policy Service Representative - October 2012 – June 2015 Primary duties include:

Professionally answering inbound phone calls from our valued customers or agents. Process requests from clients, agents, and other external customers while maintaining a high degree of efficiency and accuracy.

Verifying information received (correspondence writing, mailing, e-mailing, faxing and customer call backs).

Manage daily work queues and data entry within both Windows and mainframe environments. Work on special projects as needed.

Knowledge of various systems including IRSA, CORE, AWD, CK4, VECTOR, LIFEPRO,UPIPROD, RESP, TRECS, Policy Specimen Library, TPX Training Course: AHIP Health Insurance Advance Studies - certification completed. Aerotek Temp Service – Renaissance/Delta Dental Insurance; Indianapolis, IN - May 2012- July 2012 Full-time 40hrs per week

Customer Service Representative

Primary duties include:

Provide group member dental eligibility/benefit information Provide dental claim payment status; process claim adjustments Process member eligibility updates

United Healthcare - Golden Rule Insurance; Indianapolis, IN - January 2009 – May 2012 Full-time 40 hrs per week

Associated Enrollment/Eligibility Rep

Primary duties include:

Prepare, process, and maintain new member or group enrollments Respond to member eligibility or group questions and verify enrollment status AmeriChoice- United Healthcare Indianapolis, IN - May 2005 - December 2007 Full-time 40 hrs per week

Call Center Customer Service

Primary duties include:

General inquiry, outreach and education for the Indiana Medicaid Health Programs Respond to member eligibility or group questions and verify enrollment status While following all PHI and HIPPA guidelines: provide problem resolution and intervention, health plan and PMP selection and/or changes, referrals to other resources, documentation Electronic Data System Indianapolis, IN - June 1990 – February 2005 Full-time 40 hrs per week

Data entry clerk

Primary duties include:

Enter HCFA 1500, UB 92, and Dental claim data in system. Process and adjudicate suspended HCFA 1500, UB 92, Dental claims and returned Claim Correction Forms

Customer Service Rep

Primary duties include:

Provide a timely and accurate response to oral and written inquiry from the IHCP Medicaid providers concerning claim status, recipient eligibility, reimbursement methodologies, general billing information and ensure PHI regarding HIPAA guidelines Business Analyst/Managed Care Organizations Enrollment coordinator Primary duties include:

Develop change orders and test plans to implement system changes or corrections in support of the managed care programs

Monitor, support and analyze the managed care program functions – including utilization, provider/recipient enrollment and disenrollment internal/external training to managed care entities regarding PMP enrollment procedures/processes EDUCATION

Broad Ripple High School, Indianapolis, IN

Completion date: August, 1985

Kaplan College, Indianapolis, IN

Completion date: November, 2008

Contact this candidate