Candidate Information Name Available: Register for Free Title Customer Service Claims Representative Target Location US-FL-Tampa Email Available with paid plan Phone Available with paid plan	20,000+ Fresh Resumes Monthly     View Phone Numbers     Receive Resume E-mail Alerts     Post Jobs Free     Link your Free Jobs Page     ... and much more Register on Jobvertise Free
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EMAIL AVAILABLEPHONE NUMBER AVAILABLEAuthorized to work in the US for any employerWork ExperienceClaims RepresentativeCentene/Sunshine Health Plan - Tampa, FLJanuary 2022 to January 2024 Utilize a variety of virtual tools, including Outlook email, Cisco Webex, and similar applications, to effectively collaborate, communicate, and stay connected with colleagues and supervisors. Analyze account benefit plans to ensure claims align with coverage and policies. Validate the accuracy of medical codes provided in claim submissions. Review and verify other insurance coverage information in submitted claim. Utilize multiple computer applications simultaneously. Maintain self-discipline, consistently uphold a strong work ethic, and complete work tasks/ responsibilities while working without close supervision. and meet daily productivity goals. Insurance SpecialistAbbVie - Chicago, ILMarch 2021 to December 2022Verify and protect patient health information accurately, ensuring confidentiality and compliance with regulations.Assist with calls enrolling in discount RX programs for specialty medications, approximately 50 to 60 calls daily (higher during peak season c. 100 calls), with calls lasting 7-8 minutes each. Utilize CRM database effectively to verify member data, record interactions, escalate unresolved cases, and complete assigned tasks as directed by call center leadership. Receive inbound and make outbound calls in a fast-paced Contact Center environment, assisting members with copay assistance enrollment, case inquiries, requests, and concerns. Dental Customer Service RepresentativeLIBERTY Dental Plan - Tampa, FLNovember 2019 to December 2020 Learning and mastering dental terminology to remain up to date on products offered. Required to demonstrate specialized critical thinking skills in relation to dental field with proficiency. Demonstrates responsibility for timely, effective and accurate processing of technical questions for cases. Follow up with Dentist clients as necessary on technical questions and remake/repair related dental matters, with a strong focus on complaint resolution and retention to build better rapport with clients. Heavy telephone and email communication; must have ability to multitask and prioritize tasks in a fast pace environment. Communicates and documents critical information according to the established policies and procedures EducationHigh school diplomaPenn Foster - Philadelphia, PAJuly 2008 to November 2009Skills ICD Coding Insurance Verification Acute Care Inpatient medical coding experience facility. (2 years) Windows Customer service Anatomy knowledge Zendesk Typing Medical coding Conflict management Salesforce ICD coding ICD-10 ICD-9 Microsoft Access Medical terminology Microsoft Office Customer support Patient monitoring Care plans Patient monitoringCertifications and LicensesDriver's License