| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidateCandidate's Name
Street Address Bellissimo PlaceHowey in the Hills, FL Street Address
PHONE: PHONE NUMBER AVAILABLE EMAIL: EMAIL AVAILABLEProfessional SummaryOver 22 years of professional experience in telecommunications and managed care. Recognized for problem-solving and leadership qualities. Skilled in building cross-functional partnerships, demonstrating exceptional communication skills, and executing critical thinking.Relevant ExperienceUSAAOrlando, FLBanking Specialist2021 to currentAssisting callers with Banking needs, such as Balances, setting up and Transferring Funds to external accounts, request updates on accountsAssisting with opening new accountsLiason with other Banking DepartmentsPlumbers Local 130Chicago, ILClaims Processor2016-2021Review and process EDI, Major Medical, and Medicare claims and adjustments.Aid various constituents with health insurance benefits, eligibility, and claim status including educating retirees about future benefits.Maintain ongoing communication with vendors and contractors (Hines & Assoc and PNA) to sustain productivity.Train and mentor new recruits on enrollment processes and procedures.Ensure fulfillment of all internal and external requirements and compliance regulations.American Medical AssociationChicago, ILClaims Processor II2006-2014Reviewed and processed medical claims for Medicare Supplement Plans.Managed copious amounts of EDI and Error Report claims as well as processed paper claims.Processed refunds and letters of receipt.Liaise with departmental colleagues and external collaborators to coordinate claims and/or processes for completion.CSI AgencyOak Brook, ILMedical Review Analyst2005-2006Reviewed medical records to determine pre-existing conditions applicability for policy holders and dependents.Initiated investigative searches for members and/or policy holders to process pending claims.Monitored pending claims for processing approval and notified policy holder(s).UnicareChicago, ILSenior Customer Service Representative1999-2004Assisted clients with claim status, benefits, and payments.Informed policy holders of plans and policies.Troubleshot and resolved client issues and complaints.Assisted supervisor with special projects.EducationLife, Health and Annuity -215State of Florida2021Bachelor of Business AdministrationNational-Louis University, Chicago, Illinois2007Associate of ArtsCollege of DuPage, Glen Ellyn, Illinois2005Volunteer ServiceCorporate Community Schools of America 1988-1990Alpha Communications 1990-1995Good Samaritan Hospital 2005-2006Medeas Kitchen 2006-2012SkillsProficient in MS Office: Microsoft Word, Excel, and PowerPointAdvanced working knowledge of Hanstart, Basys Network, and Star ProgramsReferences available upon request |
