Data Entry Health Insurance
Resume:
Robbyn Evertsz-Culler
Cohoes, NY *2047
********@*****.***
I am seeking Data Entry employment working from home.
For the past three years I was a caregiver for my mother in GA. Now I am back in NY with my family.
Work Experience
Senior Dental Claim Approver
Emblem Health Insurance - Albany, NY
April 2019 to October 2020
Applied training,, policies and procedures to evaluate, correct and approve dental claims as required for settlement. Evaluate inquiries of dental subscribers and providers of service to determine correctness and accuracy of payment. Generate letters through the letter generating system as needed. Data entered coded claims from areas into the mainframe platform.
Verification Document Administrator
Maximus, Inc
June 2014 to April 2019
Reviewing, updating, and processing applications in the Marketplace for individual consumers, and their families to get health insurance. This entails verifying that all applications have been filled out correctly, and checking all documentation submitted. I work on Special Projects that included (Immigration/ Citizenship, SSN/Citizenship for Infants up to the age of one extending their due dates so not to affect their eligibility. I assist with the training of new hires. I help out in other departments when asked. I also perform other duties as assigned by leadership.
Scheduler
IMA Group - Colonie, NY
March 2014 to May 2014
(Part-Time Temporary)
Taking incoming calls and making outbound calls to schedule consult exams for claimant's Social Security Disability claims. Entering claimant information and appointments into a computer database.
Office Assistant
First Choice Evaluations - Colonie, NY
May 2012 to May 2013
Checking in patients for their Independent Medical Exam and answering phones. Processing medical records to be given or sent to the Physician. Scanning medical records into Fortis Document Manager. Filing and Data Entry.
Customer Service Representative
Maximus, Inc - Albany, NY
May 2011 to May 2012
Handle a large volume of inbound calls for Medicaid, Family health plus and other NYS programs. Resolve customer inquiries/concerns quickly and efficiently. Communicate plans and coverage information to a wide variety of customers, . Conduct and process renewal applications by phone, email, web or direct mail, etc. Observe client confidentiality requirements with integrity. Read and interpret company documents to relay information to customers. Accurately record information obtained from customers into client database. Interpret information and make decisions based on client policies and procedures. Participate in team meetings, solicit feedback and share information with management.
Education
High school diploma or GED
Some College - AOS Medical Assistant
Skills
• Operating Systems (10+ years)
• Cold Calling
• Medical Records
• Microsoft Windows
• Technical Support
• Computer Networking
• Customer service
• Negotiation
• Time management
Additional Information
Microsoft Office: Word, Excel and Powerpoint; Operation System 98, Windows XP and Windows 7. CBSIS Billing System, ICOM Billing System Remedy. Amysis, Maces and Facets
(for documenting and call-tracking system). Medical Manager, Intergy and Escribe Service, Care Connect and Member/Provider Connect, eMedny, Maxe, The Marketplace, OKM and WATS.
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