Hard-working dad looking for a great telecommuting opportunity

TOMMIE THOMAS

*** ****** **, ****** ******, N.Y. 10303

(W) 631-***-**** / (Mobile) 646-***-****

Experience:

ELDERPLAN, Brooklyn,NY 12/07-Present

Processing ElderPlan Claims Based on Elderplan Payment Policies and State Law.

Resolving Pended Status Claims Based on Elderplan payment Policies and State Law.

BLUE CROSS BLUE SHIELD, Melville, NY 02/05-11/07

Membership Representative

Enrolling members and groups into the Blue Cross Blue Shield Plan.

Filing paperwork containing sensitive member and group information upon completion of entering the information by computer.

Correspondence via telephone with current and prospective members to obtain pertinent enrollment information absent from the application.

AFFINITY HEALTH PLAN, Bronx, NY 10/01-01/05

Insurance Claims Approver/Enrollment Representative

Processing Affinity Health Plan Claims Based on Affinity Payment Policies and State Law.

Resolving Pended Status Claims Based on Affinity payment Policies and State Law.

Answering Phones and Resolving Inquiries/Problems Encountered by Members and/or Providers.

Reviewing and entering applications of prospective members of Affinity Healthplan as an Enrollment Rep.

ORTHONET, White Plains, NY 6/00-9/01

Insurance Claims Specialist

Processing Oxford Insurance Claims based on Oxford policies and State Law.

Entering MDNY Insurance Claims Information.

Processing MDNY Insurance Claims Based on MDNY policies and State Law.

Insurance Claims Auditing.

WORLD RESEARCH GROUP, New York, NY 2/00-6/00

Customer Service Representative

Registered customers for conferences for WRG by computer.

Resolving phone and computer inquiries.

Heavy clientele contact.

Filing, typing, faxing, answering phones.

CCN MANAGED CARE, White Plains, NY 8/99-2/00

Network Operations Assistant

Responsible for maintaining data integrity.

Initiated organization of files for efficiency in processing.

Screened and reviewed physician’s applications.

Managed technical function of provider information contained in CCN database (SAS).

Spoke to office managers and/or providers by phone in an effort to resolve outstanding issues.

Education:

JOHN JAY COLLEGE, New York, NY

Major: Legal Studies 9/88-5/92 (100 Credits Earned)

Skills: Proficient Knowledge. Amisys, Application Information Systems, MS Office/Excel, Word, SAS.

REFERENCES AVAILABLE UPON REQUEST

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