Customer Service Data Entry

PEBBLES D. JAMES

**** ******** **., ********, **

Cell: 803-***-**** • Email: ************@*****.*** 1

EXECUTIVE SUMMARY: Versatile, research associate with more than 10 years of data entry; research and customer service experience. I have a keen ability to manage multiple pipelines and tasks. With a strong communication skill that aid in building collaborative relationships to benefit the company needs.

QUALIFICATIONS:

Strong communication skills

Well-developed research, organizational and analytical skills

Solid problem-solving abilities

Ability to work independently and resolve complex problems

Exceptional Customer Service

COMPUTER SKILLS:

Proficient in Microsoft Office: Excel, Outlook, PowerPoint, Word, Access PROFESSIONAL EXPERIENCE:

Blue Cross Blue Shield of SC, Columbia, SC

Percival Road (Office)

August 2023 to Present

Provider Enrollment Analyst

May perform any or all of the following in the enrollment of providers determines the acceptability of provider enrollment applications (which may be used for initial full application, reenrollment, reactivation, change of information); provides in-depth review and verification/validation of provider data; verifies provider data by use of information databases and various organizations/agencies to ensure authenticity; sets up/tests EFT accounts.

Processes/enters/updates provider data information/applications into appropriate enrollment database used in evaluating/tracking the processing of the application and/or updating of provider directories.

Provides quality service and communicates effectively with external/internal customers in response to inquiries (correspondence, telephone). Obtains information from internal department, providers, government and/or private agencies, etc. to resolve discrepancies/problems.

Supplies enrollment applications and general information on the enrollment process to interested enrollees.

Contributes to and participates on special projects related to provider files. Assists Technical Support staff with testing system changes related to provider files. Assists with process improvements related to Provider Enrollment. Assists with provider education and provider services training. Work environment: Typical office environment.

PEBBLES D. JAMES

2606 Palmland Dr., Columbia, SC

Cell: 803-***-**** • Email: ************@*****.*** 2

Palmetto GBA, Columbia, SC (Office)

April 2023 to August 2023

Jurisdiction J Provider Enrollment, Data Preparation Technician II Reviews, extracts and analyzes data to be used in formulation of procedures, processes and other requirements. CMS 855A, and 855B enrollment application Provides reports of relevant activity to be used to identify problematic areas and to provide basis for modification and/or elimination of operations issues. Assists with development of complex analysis and sophisticated data compilation, verification, and interpretations to guide divisional efforts.

Performs focused analyses as needed.

Creates data search programs to identify pertinent data needed to provide supporting documentation for system or operational enhancements/changes. Documents reporting procedures so other staff can run ad hoc reports independently. Palmetto GBA, Columbia, SC (Home)

March 2020 to April 2023

Palmetto GBA, Columbia, SC (Office)

May 2018 to March 2020

Professional Management Enterprises, Columbia, SC

June 2016 to May 2018

National Supplier Clearinghouse Central, Data Preparation Technician II Performs varied clerical duties accordance to standard procedures in National Supplier Clearinghouse, Sort and distributes incoming workflow of standalone document ( Surety Bond, License, Certificate of Insurance, EFT, Voluntary Termination) This includes clerical duties such as Centers for Medicare & Medicaid Services (CMS) DEMPOS enrollment documentation (CMS-855S,) working within I-Flow. WebPort. and PECOS, filing, tabulating, posting information and distributing mail. Applies knowledge of department policies and procedures and uses a general understanding of other departments' functions to resolve most issues. May assist in orienting and training others. Serves as an information source for both internal and external customers by answering complex customer service inquiries via telephone, e-mail, and/or web inquiries. Inquiries are non-routine and require deviation from standard screens, scripts, and procedures. TJ Maxx, Columbia, SC

November 2007 to September 2018

Customer Service Coordinator

Assistant to Operations Manager: Provide exceptional customer support, intervention, and resolution to escalated customer complaints. Supervise sales associates by delegating tasks, monitoring schedules; and offer mentoring and training to sales associates. Opening and closing the registers daily, handling cash transactions for cashiers and training. Making daily cash drops from cashiers for deposit

PEBBLES D. JAMES

2606 Palmland Dr., Columbia, SC

Cell: 803-***-**** • Email: ************@*****.*** 3

Wells Fargo Home Mortgage, Columbia, SC

March 2010 to June 2015

Research/Remediation Associate

Manage multiple pipelines. Responsible for responding to and/or researching and resolving escalated inquiries and complaints. Communicate with various parties to include clients, executives, agencies, regulatory/governmental representatives, bankers, etc., to ensure resolution of escalated matters. Ensure identified risks and/or problems are clearly documented. Validate bankruptcy status for all files pending foreclosure sale within seven business days. Loan Servicing Specialist 3

Responsible for researching assigned Office of the Comptroller of the Currency (OCC) Consent Order High Risk foreclosure cases, identifying harm and errors, if applicable. Maintained a working knowledge of foreclosure procedures and offered recommendations based on my findings as to proceed with foreclosure or not.

Home Preservation Specialist 1

HAMP/ FNMA/ FHLMC Modification: Customer education and mentoring through the Making Home Affordable Program. Processed files for submittal to underwriting. Ensured files were in adherence to guidelines and regulations. Customer service and follow up. Maintained spreadsheets, managed workflow, ordered appraisals and titles where appropriate. Teleperformance (DirectTV)

May 2009 to March 2010

Technical Support / Billing Agent( Call Center)

Provide direct client support via inbound phone, chat and e-mail. Help customers troubleshoot issues with a piece of equipment (remotes, receivers, and satellite) how to use the service, and resolve billing & technical issues

Doctors Care, Columbia, SC

January 2008 to May 2009

Accounts Receivable (Medical)

Maintained and exceeded daily requirement of electronic/live check payment postings and completed lockbox reconciliation the accurate and timely posting of all charges, payments, adjustments and denials into the Practice Management System. Balance totals of all financial activity posted to patient accounts prior to daily close. Perform daily closing of assigned datasets and provide appropriate documentation to be archived. Generate patient statement and insurance claim files as instructed. Transmit batches electronically according to established procedures. PEBBLES D. JAMES

2606 Palmland Dr., Columbia, SC

Cell: 803-***-**** • Email: ************@*****.*** 4

Facilitate processing of all active claims and statements. Perform account collections. Provide customer service for patient account inquiries.

Accounts Receivable Collections, Lexington, SC

November 2006 to January 2008

Administrative Assistant/AP&AR (Medical)

Generated & distributed daily, weekly and monthly reports. Applied payments to patients/debtors outstanding account balances by electronic posting, lockbox, and credit & debit card reconciliation, completed new business account setup. Transmitted files to bankruptcy services and debtor notices to outsourcing agents. Carried out the end of the month closing reports. Analyzed and performed error-free data entry with accuracy and precision. Work from home when needed

Netbank (formerly RBMG), Columbia, SC

September 2002 to November 2006

Senior Loss Mitigation Specialist/Collections ( Call Center) Controlled daily reports/queues as required. Handled all other duties as assigned to support coordinator and supervisor. Assisted customers in repayment plan/forbearance/mortgage loan modification programs. Applied mortgage payments. Effectuated research and problem solving on accounts in timely manner. Maintained inbound and outbound calling campaigns. EDUCATION:

Medical Billing and Coding Diploma, Remington College, December 2010 SKILLS/TRAINING:

Billing and Coding - ICD-9 and CPT coding, claims processing and follow up, knowledge of insurance, medical records management, and terminology

Software - Windows ‘00, Internet, Microsoft Office (Complete), Microsoft Edge, CTC Dialer Debt Net, Medisoft, Fidelity, Early Resolution, Black Knight, i-Flow, PECOS, PIMS, Rumba

Training - CPT and ICD-9, Collection Skills for Loan Counselors (web course), Pretext Calling & Identity Theft, Professional Skills for Customer Service Agents, Basic Privacy and Information Security, Fair Debt Collection Practices Act, SEC 2023 Security Awareness Training, Information Systems Security and Privacy Awareness Training (CMS), PALM 2022 Annual Fraud and Abuse Awareness Training

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