Customer Service Lead

Michell Muldrow

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

Greensboro, NC 27406

333-***-**** Resume

Work Experience:

****-******* ****** ****** ***** Greensboro, NC

Claims Representative- Healthcare :

Process claims, that route out of automatic adjudication, within current turnaround standards

Apply plan concepts to include: Deductible,Coinsurance,and Copays

Review state variations related to variable deductible, coordination of benefits, carve-out and alternate benefits.

Recognize potential pre-existing conditions, misstatements and fraudulent claims

Process correspondence and requests for reconsideration within time service standards

Use pre-approved electronic letters as well as handwritten letters to communicate with customers, providers, attorneys, regulators and other external entities

2004-2008 Anthem Blue Cross Blue Shield Roanoke, VA

Medical Representative- Healthcare Operations:

Asst. Manager with customers inquires

Knowledge of Healthcare plans including Managed Care

Work with Operations areas including membership, claims, and medical

Organizational skills to complete task daily and train new associates

Utilize computer and office equipment daily

Prioritize daily workflow of task and assist customer with inquiries daily

Call Center Support, Determine healthcare eligibility HMO, Managed Care claims, Extensive Healthcare

knowledge, Medical Records Review

2001-2004 Consolidated Edison Brooklyn, NY

Professional Customer Service Leader:

Responsible for interviewing customers daily

Consultant to managers

Demonstrated use of internet and computer systems

Problem Solver, input data, handle emergency calls daily

Make decisions concerning customer accounts

Assist with training of new employees claims

Review customer accounts daily

Process applications for service connections

Call Center Support, monitor calls, assist customers

1988-2001 W. International New York, NY

Front Line Operations Manager

Responsible for retention plan, orientation of new employees

Recruiter for local positions at the hourly and salaried rate

Interview candidates for openings

Maintain correct levels of inventory

Assist with customer service issues

Responsible for daily operations of the business

Education:

Boys & Girls High School Brooklyn, NY

Customer Services Courses completed , CPT Codes, Claims Processing, Medical Terminology

Management/Supervision courses completed

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