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Click here or scroll down to respond to this candidateCandidate's Name
ADDRESS Street Address
PHONE PHONE NUMBER AVAILABLE EMAIL EMAIL AVAILABLEEmployment Objective: To expand my knowledge and skills providing total quality service. The ability to educate, training, and perform the requirements to all recipients. SUMMARY OF QUALIFICATIONSCustomer service, organizational skills, task management, developing with excellent public relations in a Health Care environment. Department lead business analyst for a national health insurance company. I possess strong personal, organizational, verbal and written communication skills. I am self-motivated, pay strict attention to detail. I have great leadership skills working with internal and external customers. I have exceptional communication and listening skills, strong leadership qualities, the ability to manage problem issues, adaptability to changing business or customer needs, and demonstrate success in coaching and mentoring employees. I have experience with multiple computer programs such as, Microsoft Word, Excel, Medical Terminology and Blue Recruit. I know how to manage individual quality, production, training in medical coding, new procedures, and processes. I am able to recognize any training needs the individual needs to help improve their overall job performance to be successful. The employees or HIPPA covered entities to use wherever they are within a health plan in electronic transactions. Sometimes change can be a very difficult process. With knowledge, education, communication and patience the success for the payer will be successful. . I am a Team player and enjoy working with others. Developing plans to meet service contract requirements. Ensuring employees and teams meet other corporate objectives, service quality, site excellence and continuous improvements. Providing leadership, training and career development for employees for Claim Processing, Medical Coding, Customer Service, and Coordinating employee evaluations, hiring, discipline issues, career development and other job duties are as assigned. I traveled frequently to Chicago, IL and Texas for presentations, training, and system enhancement for pricing changes, coding flows, and career development.PROFESSIONAL EXPERIENCEMemorial Health Systems09/03/13 Reimbursement Financial SpecialistProfessional billing services to determine eligibility for patients and medical Clinics. Update Medical insurance, credentialing for doctors and nurses. Customer service inquiries, review for Insurance, posting claims, and adjusting payments. Provide training to better service the internal and external customers. Marketing Alternatives Incorporated102012-012113 Customer Service Representative/Trainer/Floor Support Assistant This was a seasonal position to market for Figis account sales. I was very successful in providing customer service for the internal and external customer. I was there for two weeks and they promoted me to the trainer for this account and floor support.Diamond Brothers InsurancePHONE NUMBER AVAILABLE Insurance ProducerProvided customer service to quote insurance policies for Property Casualty and Automotive Insurance Policies with the best rates for each customer. . I received mycertification through the State of Illinois to be able to sell and quote insurance policies. Assisted with inquiries, accident reports, answering the phone, and assisted walk in customers. I also went to offsite meetings to represent Dimond Brothers Representative. Blue Cross Blue Shield Association1990 2009 Claims Supervisor, Springfield, ILTo manage individual quality, production, training of procedures, diagnosis, CPT codes, Coordination of Benefits, HIPPA, and Compliance, ICD-9, operative reports, M.D. Certifications, Medicare, Medicaid, member paid claims, provider submitted, Tpl/Inv coding, and CPT Modifiers. I am able to recognize any training requirements the individual needs to help improve their overall job performance to be successful in reports, policies, and pricing logic. Application screening, hiring, and termination of job assignments. I attended all management meetings on or off site, managed internal and external employees, provided presentations, travel, and monitor inventory. 2003 2005 Developmental Specialist, Management Springfield, IL Design of company application enhancements and quarterly deployment releases. Generate business requirement documentation, acting liaison between Information Technology developers and 500+ customer service divisions within a 4 state region. Perform gap analysis to integrate functionality and reporting between procedures and policy changes in the medical coding. . Coordinate and perform user test cycles for quarterly implementations, ensure the applications performance and functionality met and or exceeded company standards. Development of experienced and new hires of any new system enhancements, 1989 2003 Health Insurance Specialist Springfield, IL Subject matter expert in inventory processing related inquiries. Ensured that over 200 employees were adhering to corporate service level agreements for major accounts, extensive data entry, facilitated classroom and peer training sessions. Managed communication points between corporate advisers, providers and patients for medical service advisory requests for coding and processes to implement overall quality assurance, accuracy, and production. EDUCATIONLake Land Community College for Business Administration Medical TerminologyHigh School diplomaCodepedia - Online Self-Study ICD-10SKILLSMedical Coding/Medical Terminology, Customer Service over 19 yrs. of experience. Excellent with Microsoft Word and ExcelExcellent understanding of the ICD-9 and ICD-10 coding PROFESSIONAL MEMBERSHIPS/AWARDSMost Supportive Employee for training, implementing coding, procedures, Medicare, New Business, and processes.Several Awards for going over and beyond my job expectations as duties are assigned Awarded for Perfect Attendance several years in a row. |
