Data Entry Customer Service
Resume:
CYNTHIA BOLTON INVESTIGATION
Cynthia Bolton ********@*****.***
Business Investigation license State of Nevada : NV20253276477
Las Vegas, Nevada 89115
SUMMARY
I have contacted multiple employers to make sure their recruiters do their jobs. Recruiters retraining, and I conducted research clinical reviews to determine the appropriateness and necessity of medical treatments and services. Here are some specific examples: Clinical Reviews: She conducted clinical reviews to determine the appropriateness of treatments and services, using InterQual and Milliman guidelines. Case Assessments: Ms. Bolton completed case assessments accurately and in a timely manner, utilizing InterQual to ensure that all necessary documentation was included for accurate assessment. Documentation Reviews: She reviewed patient treatment records and medical histories for accuracy and completeness. Coordination with Insurance Companies: Ms. Bolton coordinated with insurance companies to facilitate the processing of claims and provided required documentation. Case Reviews: She prepared and sent patient case reviews to physicians for further evaluation Well versed in health care management, data entry, outpatient and inpatient management, care management, risk management, revenue cycle, patient billing, insurance, eligibility, appeals, verification and authorization, resource management, and proficiency with KPI reporting. Expect in Hospital setting with UCLA, UMC, ST. Rose Dominican Hospital, ST. Bernardine, UC Davis, UHC. Capable of working with tight deadlines, attention to detail, and customer service oriented. I now a license Investigation in the state of Nevada
Skills:
•Epic
•ROI Specialist • Employee Onboarding • Customer service
•Scheduling • Clinical review • private insurance
•Microsoft Office • Data Entry • Problem Solving
•Medical records • Inpatient & Outpatient • Organizational Skills
•Administrative and clerical support • Verbal and Written
•Hospital setting Communication
PROFESSIONAL EXPERIENCE
Amazon
06/2024 to current
Disability & Accommodation
Corporate Headquarters: 9505 Hillwood Drive, Suite 150, Las Vegas, NV 89134 Phone: 702-***-**** Fax: 702-***-****
Locations in: Philadelphia, PA; New York, NY; Denver, CO; Aiken, SC; Layton, UT; Reno, NV; Phoenix, AZ
•Disability, accommodation, restrictions
•Monthly reports
•Retraining
•Insurances Benefits
•Research
•validates, and/or edits codes/DRGs and abstracted data
•corresponding Present on Admission (POA)
•Procedure description with appropriate 7-digit ICD-10-PCS code, date and surgeon
•LOA Diagnosis for employees on medical leave
•Maintains or exceeds established accuracy standards • Maintains or exceeds established productivity standards
•Utilizes the complete patient medical record documentation in code/DRG assignment, validation, and/or editing of codes/DRGs
•Initiates, reviews, and/or edits physician queries in compliance with Company and HSC policy where appropriate
•As needed, may periodically be asked to perform Coding Account Resolution
•Staging, floater
•Eligibility
•Data entry, correcting employee’s demographic, faxing documents to physician.
•Processing vendor returns,
•using an RF Scanner for stock transfer, conducting cycle counts, and refurbishing returned merchandise.
•Inspect products for quality standards
•Manage inventory controls using quality assurance methods, and process customer returns. Audits and Projects
Maximus TriWest 03/2024 current
•CSR Operational
•Scheduling Veterans Appointments
•Contact assessment/preferences assessment.
•Handling veterans’ inquiries and problems via telephone
•Work in variety of systems to perform required tasks.
•Calls are predominantly routine, but may require deviation from standard screens, scripts and procedures.
•Performs other tasks as assigned by leadership.
•Research for missing information, coordinate with other departments.
•HSRM, CareRaduis, Vetconnect, FMax
VRC ROI Specialist 12/2023 – 02/2024
•TRA medical imaging,
•Pulling medical and billing records for lawyers, court and patients
•Entering data entry for primary & secondary
•Critical thinking
•Patients account
•Data entry
•Bulk request
•Referral & authorization
•Insurance verification
•Verification of patients Identities
City of Pasadena CA Remote 01/2022 – 12/2022
•Responsible for answering high volume inbound calls and providing effective quality customer service regarding property damage claims.
•Supported borrowers and contractors by providing detailed information on how to progress a claim file, de-escalate calls, process complaints, and handle disbursement of claim funds.
•Verified eligibility requirements such as, mortgage claims, cancelation, and renewal.
•Utilized software such as: MSP, Interaction matrix, Workdays, Genesys, workday.
Arizona State Unemployment Center - Remote 08/2021 – 12/2021
Adjudicator
•Processed unemployment benefits for claimants and provided client support, including education on the UE claims process.
•Gathered and compiled documents and prepared written responses to state agencies.
•Communicated with claimants via telephone to gather claimant separation details, case preparation, and determine eligibility.
•Utilized software such as: AZ PUA portal, OnBase scan documents, Genesys chat app, OnBase, Guide system, review incoming, eligibility.
Raider Transportation LLC – Remote 05/2021 – 07/2021
Recruiter
•Reviewed applications and resumes.
•Screened and tested applicants and responded to applicants’ inquiries.
•Scheduled and conducted interviews by calling candidates, confirming dates and times for interviews, and followed up with department leaders for results of interview. Made 150 calls a day and maintained contact with drivers every other day to make sure they remain connected with assigned truck company.
•Assisted with onboarding process by managing the candidates’ documentation. I-9, orientation training, drug screening.
•Assisted with additional tasks consisting of bookkeeping and other administrative tasks.
Express Employment – Stockton, CA 04/2021 – 05/2021
Customer Service Specialist
•Performed general clerical duties including, bookkeeping, filing, data entry, answering phones, documentation, emailing, schedule appointments, conducting group interviews, preparing reports using Microsoft Excel, constructing memos using Microsoft word.
•Assisted with interviewing process.
Acelis Connected Health/Abbott – Remote 07/2020 – 09/2020
Benefits Administrator
•Verified benefits, active insurances policies, Medicare eligibility, referrals, clinical, and PCP referrals.
•Performed clerical duties such as: data entry, outbound and inbound phone calls, data collection from patients, preparing prescription forms, and clinical review.
•Assisted with ordering supplies for Human Resources office.
•Performed codes such as ICD-10, DX codes, generated RX, RX cases, CPCS, ICD9.
•Educated medical providers and clinical personnel to use appropriate coding.
•Assisted with on-boarding process, filing documents, creating badges, and posting jobs positions.
Sonoma County DOH – Remote 08/2019 – 01/2020
COVID-19 Contact Tracer and Investigator
•Contacted positive or negative people for COVID-19, process documentation, making sure people are being isolated or quarantine, sending out Orders, giving out clearance letters to return to work.
•Documented names and contact information of all individuals who have had contact with a COVID-19 patient.
•Assisted with clerical tasks including, verified insurance policies, called providers to confirm eligibility, conducted online interviews.
•Assisted with onboarding of Contact Tracer new hires by assisting candidates with I-9 and W4 documents, scanned and filed documents, conducted group interviews, and data entry.
California Rural Legal – Stockton, CA 02/2019 – 03/2019
Legal Assistant
•Provided clerical support such as: filing documents, led workshops, data entry, bookkeeping, scheduled appointments, collected payment for detainer, performed intakes, and verified proof of services.
•Executed and monitored the preparation of legal documents.
•Recorded data into internal systems.
•Examined court and legal documents for proper authorization and obtained missing signatures; referred documents to the proper staff.
o Eviction notices and 3/30/60 day notices.
Amazon – Stockton, CA 04/2019 – 12/2020
Human Resources Assistant
•Supported associates and managers with routine and daily HR questions, needs, and inquiries.
•Provided leadership development support to onsite Operations leaders.
•Facilitated the internal recruitment process by coordinating internal job requisitions, scheduling interviews and administered the associate internal transfer portal.
•Assisted in recruiting candidates by coordinating new hire orientations and interview loops.
•Assisted with training and development tasks including safety training, warehouse associated policies and procedures, scanning, implementing social distancing and hand washing.
Delta Protected Services – Stockton, CA 03/2019 – 10/2019
Human Resources Assistant and Dispatcher
•Aided with onboarding process, scanned documentation, created badges, confirmed uniform sizes, filed documents, front desk support.
•Appointed the point of contact for no call no show, call outs, and timecard collection.
•Assisted with form completion, filing, and review to assure completeness and accuracy.
•Utilized Microsoft Word and Excel to compose memos, reports, materials, spreadsheets, forms, and other documents as required.
•Implemented and assured all security personnel were following all rules and regulations.
o Monitored the safety of security officers in the field.
•Verified employment status of staff.
• Expertise In hospital setting 10/1994 – 11/2018 • for Inpatient vs Outpatient at UCLA, Santa Monica, UC Davis hospital, Dameron hospital, UMC hospital, UHC, ST. Rose Dominican Hospital, ST. Bernardine Medical Center, IEHP Medical Group, UHC Insurance, SCAN Insurance, OPTUM medical group, San Bernardino Convalescent & San Bernardino hospital
EDUCATION
Certification and Business License investigation
Owner of Cynthia Bolton Investigation
Nevada State Business License Identification: NV20253276477
Nevada state permit Account ID: SUT-000*-****-****
Location ID: 000-036-143-895-001
•California State University, San Bernardino
•Coding and billing certificate
•Compliance and Risk Management Certificate
•Medical Records Management Certificate
•Clinical Radiology with Evaluation Certificate
•UEI Business office Administrator
•Attending CSN for refresher course medical coding
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