Customer Service, Medical Insurance,

Karen Michels

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

Aurora, CO 80014

Phone: 720-***-****

Email: *******@*******.***

QUALIFICATIONS

File clerk, Supervisor for over 5 years for Customer Service, Clerical Department and Medical Claims Department, Special Services Representative/Appeals Specialist. Suggest changes to improve production, Put in charge of special projects. Interpreted Plan documents and built on the Rims system for payment of medical, dental, short-term disability and long term disability claims. Maintained the Rims system for all amendments , tracked all information received for any type of communication that involved my work area. Problem solving, hiring and firing employees. Provided employees with their reviews. Reviewed appeals and wrote letters to members with the results of my review.

EDUCATION

1967 North Penn Jar & Sr High School graduate

1993 Certified Nurse Assistant

1983 Accounting course in Europe

EMPLOYMENT

2006-2008 Special Services Representative/Appeals Specialist CoverColorado

I answered phone and provided service for complaints, appeals and aided Brokers/Agents with CoverColorado’s policy for enrollment. I also covered co-workers desks when they were out of the office. I provided reports regarding applicants approved for coverage, members that termed their coverage

EMPLOYMENT

1994-2005 Plan designer CNIC Health Solutions

The first position was claims adjuster and in three months I trained to build Plan documents on the Rims System for claim payment. Along with this responsibility I was also Supervisor of Customer Service and Clerical Department. I constantly was on the computer with the Rims program and fixing bugs, updating accounts when there were amendments to their benefits. I managed and maintained over 600 groups. I used Word and Excel programs for organizing the departments I supervised and writing letters to our Clients. I provided customer service and resolved problems . I took on extra responsibilities where needed.

EMPLOYMENT

1993-1994 Nurse Assistant John Mumford

I provided health care to Mr. Mumford who is a Quadriplegic. This job required me to drive Mr. Mumford to all his Public Speaking engagements. I also transferred Mr. Mumford from his bed to his wheel chair.

EMPLOYMENT

1988-1993 Long Term Disability Claims, Great West Life

I processed and investigated claims to determine allowable benefits. After two years, I transferred to a different department. My responsibilities were to evaluate our documents and procedures and suggest ways that the company can provide better tools for all their employees. I also responded to Attorneys and Insurance commissioners for any insurance procedure complaints.

EMPLOYMENT

1983-1988 Claims and Clerical Supervisor, Mountain States Administration

My first position was File Clerk. I stamped in all mail, passed out mail, and filed. After 3 mo., I was asked to go into training for paying medical, dental claims and at the same time be supervisor of the File Clerks. Two years later I was promoted to Supervisor of claims and still continued to pay claims and supervise the file clerks.

EMPLOYMENT

1980-1983 Travel assistant for Officers being stationed in Europe. US Government

I located housing for Officers and their families that were assigned Duty in Europe.

References: Amber Munson 303-***-****

Others upon request.

Salary: open for discussion

Hobbies: Knitting, crocheting, making Shabby Chic items and selling them, painting .

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