Claims & Verification Specialist with Customer Service Focus
Resume:
Inger Simon
Work from Home
Crowley, Tx *****
************@*****.***
Willing to relocate: Anywhere
Authorized to work in the US for any employer
Work Experience
Verification Claims Processor / Customer Service Representative
Taxsaverplan - Texas January 2006 to April 2025
• Customer Service/Claims Processor
• Answered phone calls for FSA clients.
• Processed claims for FSA clients.
• Took calls from customers and groups verifying Ins benefits.
Claims Adjuster Allstate Insurance - Texas April 2015 to February 2022
• Processed auto claims.
• Handled incoming calls from Ins clients.
• Managed customer accounts
• Resolved customer issues
• Worked in the inbound call center
Senior Claims Analyst/Enrollment Specialist
Aetna/Nylcare - Dallas, TX February 1994 to April 2006
Processed claims for Ins members
Input enrollment applicants for in the enrollment system.
Verification insurance Specialist / Customer Service Representative
NYLCARE HEALTH PLANS - Dallas, TX
February 1992 to February 2006
Verified insurance information. Took calls from customers and groups verifying Ins benefits. Became Supervisor for claims department which included customer service department. Billing & enrollment specialist, Insurance Verification, also claims processor and payer. Processed 1500 claims and hospital claims. Processed Nylcare 65 claims. Medicare and Medicaid. Updated and entered enrollment information into the system.
Education
High school diploma in VTI BUSINESS COMPUTER SCHOOL
Franklin D Roosevelt Senior High School - Dallas, TX January 1989 to July 1989
Skills
•Word Processing (4 years)
•Microsoft office (2 years)
•ICD 10 (10+ years)
•Managed Care (6 years)
•Disability
•Call Center (10+ years)
•ICD-10 (10+ years)
•Epic
•HCPCS (8 years)
•Advanced Excel (1 year)
•ICD-10 (10+ years)
•Microsoft Excel (6 years)
•Medical Records
•Medical Billing (2 years)
•Insurance Verification (10+ years)
•CPT Coding (3 years)
•Underwriting (3 years)
•Medical Coding (3 years)
•ICD-9 (5 years)
•Transcription (1 year)
•Hospital Experience
•Data Entry (8 years)
•HIPAA (5 years)
•ICD Coding (3 years)
•Medical Office Experience (10+ years)
•Medical Terminology (10+ years)
•Phone Etiquette (10+ years)
•Quality Assurance (3 years)
•Accounts Receivable
•Benefits administration (10+ years)
•Microsoft Word (4 years)
•Customer service (10+ years)
•10 key calculator (6 years)
•Employee Orientation (3 years)
•Clerical Experience (3 years)
•Medical Scheduling
•Adobe Acrobat
Conflict management
•Account management
•Communication skills
•Customer support
•Contracts
•Data collection
•Microsoft Access
•SFTP
Certifications and Licenses
RHIA
Medical Coding Certification
Additional Information
I’m punctual, hard worker, love to learn new things. If hired I will be a major asset to your company. Use the internet to brush up on my Microsoft Outlook and Excel.
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