Data Entry Operator Resume Summary

* ******* ****** **

Seabrook, SC *****

843-***-****

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

Lorriann L Stokes

Objective

I am an organized and driven Claims Examiner with more than 10 years’ experience in the health management industry. I would make a great addition to your team.

Experience

05/2023 – Present

Claims Associate Representative, Disputes

Research claim disputes for correct processing,

Make recommendations as to how a claim should be processed.

05/2018 – 10/2021

Client and Provider Services Representative

Identify, assess, and resolve client and provider issues and operational problems.

Investigate, recognize root causes, and determine resolution.

Responsible for any follow-up work needed for resolving and closing issues.

05/2016 – 05/2018 eviCore healthcare Bluffton, SC

Claims Research Representative

· Assist with telephonic inquiries for radiological, cardiological, and radiation therapy clams from physician offices and/or rendering sites.

· Trained in pre-certification, utilization management, NCQA and URAC principles, policies, and procedures

01/2012 – 05/2016 CareCore National Bluffton, SC

Clinical Decision Support Representative

· Assist with the clinical review process for radiological services from physician offices and/or rendering sites

· Trained in pre-certification, utilization management, NCQA and URAC principles, policies, and procedures

10/2012 – 01/2013 CareCore National Bluffton, SC

Date Intake Coordinator

· Processed clinical certification requests for radiological services from physician offices and/or imaging centers, collecting demographic information and entering data.

· Trained in pre-certification, utilization management, NCQA and URAC principles, policies, and procedures

10/2008 – 04/2010 T-Mobile USA Columbia, SC

Retail Sales Associate

· Interacted with customers to sell wireless services and associated products.

· Handled and processed all sales, returns, and payments.

· Achieved monthly sales goals

03/2003—10/2008 Suncom Wireless Columbia, SC

Wireless Sales Specialist

· Interacted with customers to sell wireless services and associated products.

· Handled and processed all sales, returns, and payments.

02/2001- 03/2003 Suncom Wireless Columbia, SC

Service Consultant

· Resolved customer service problems and issues in order to reduce to churn.

· Up-sold products and services to increase ARPU.

· Managed inventory, review records and reports.

· Performed inventory reconciliation.

1999 – 2000 Verizon Wireless Columbia, SC

Customer Service Representative

· Handled a high volume of inbound customer calls.

· Researched and resolved billing inquiries.

· Evaluated customer concerns and resolved problems to the customer’s satisfaction.

1997 – 1999 Cendant, Inc. Orangeburg, SC

Sales Coach

· Assisted with training of new sales agent.

· Performed quality assurance coaching.

1994 – 1997 Maxway, Inc. Orangeburg, SC

Assistant Manager

· Supervised up to 30 employees.

· Prepared and verified daily and weekly sales report

· Placed orders to maintain inventory.

Education

1978 – 1980 Beaufort Technical College Beaufort, SC

· Completed courses toward an Associate Degree in Office Management. Transferred to South Carolina State University before completion.

1980 – 1983 South Carolina State University Orangeburg, SC

· BA, Business Administration

SKILLS

Microsoft Word*Microsoft Excel*PowerPoint Presentation*Microsoft Outlook*ImageOne*SQL*MC400*Isaac*MCnet*Cherwell*Smartsheet

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