Customer Service Quality Assurance

Tymia Leathers

**** **** **** ***** ***** Mountain, GA 30083 Phone: 678-***-**** E-mail: *************@*****.***

Objective:

To contribute to your organization utilizing my skills and knowledge efficiently and accurately perform bill processing.

Summary of Qualifications:

Offering over 12 years of excellent customer service and claims experience

Highly disciplined, organized and goal oriented

Uses analytical and communication skills to successfully carry out responsibilities.

Proactive leader and problem solver with strong research skills

Proficient in Microsoft Word, Excel, 10 Key Numeric, Data Entry, TYPE 50WPM/ 10,000+ KSPH

Working knowledge and use of CPT-4, ICD-9, HCPCS, HCFA, UB-92 and Medical Terminology

Work History:

Bill Specialist I Crawford & Company (Broadspire), Atlanta, GA 2005-2010

Accessed and verified claim numbers in multiple claim systems.

Reviewed medical literature to resolve problems and approve claims for payment.

Reviewed and interpreted procedure codes (CPT-4), ICD-9 diagnosis codes and nature of injury to determine medical causality

Ensured activities were performed according to established schedules, client requirements, and corporate standards

Utilized internal forms and notes to communicate findings to Branch Office and providers

Accessed bill classification information to change receipt date, entered information required to complete bill adjudication.

Performed verification and research of workers compensation bills.

Assigned resolution codes to complete bill processing

Bill Provider Analyst Crawford and Company, Atlanta, GA 1998-2005

Researched claim information and authorized pending bills for payment

Assisted in mail processing, data entry, editing bill entry, adjustments, and quality assurance

Met required quality/production standards while maintaining turn around on assigned states

Determined medical casual relation, routing bills

Proof Operator South Trust Bank, Atlanta, GA 1997-1998

Operated a proof machine; sorted and proofed deposits, debits/credits,

Encoded and balanced customers account transaction

Maintained quality and quantity standards to promote effective customer service

Balanced deposits and performed a variety of clerical functions relating to check processing

Reconciled errors and made appropriate adjustments and corrections when necessary

Education:

Stone Mountain High School, Stone Mountain, GA

College Preparatory Diploma

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