| | | 20,000+ Fresh Resumes Monthly | |
|
|
| | Related Resumes Customer Service Data Entry Tampa, FL Customer Service Manager, Bookkeeping, Management, Data Entry, H Spring Hill, FL Data Entry Customer Service Westchase, FL Customer Service Data Entry Port Richey, FL Customer Service Data Entry Seminole, FL Customer Service Data Entry Tampa, FL Data Entry Customer Service St. Petersburg, FL |
|
Click here or scroll down to respond to this candidateCandidate's Name
Land O Lakes, FL Street Address
PHONE NUMBER AVAILABLEEMAIL AVAILABLEOBJECTIVEExperienced office management customer service and administrative professional optimizing productivity, efficiency, and service quality across various environments. Highly dependable, ethical and reliable support specialist and leader that blends advanced organizational, technical and business acumen. Works effectively with cross-functional teams in ensuring operational and service excellence. Proficient in Tru-care, Amyis,Portico, omni, Power Bi, File-net,MS Excel, Workday and spreadsheet, data entry abilities.CAREER OBJECTIVESeeking a fast paced, energetic environment to excel and advance professionally in order to use my leadership abilities to the optimum level abilities to assist in projects. SKILLSData Entry and Management Medical RecordkeepingSelf-motivated Proficient in Microsoft Medical Records Review Tru-care,Tru-cloud, File-netCollecting Intake Information Document ScanningClerical Support English & PortugueseAdmissions ProcessesProblem solving excellent communicationProject management resolutionEXPERIENCECentene, Tampa FL- Authorization Specialist IIIJuly 2022 - PRESENT Provided customer service in a high pace contract center environment over the phone, via live chat and emails. Maintained records and documentation for Medicare and Medicaid insurance claims Investigates problems of an unusual nature in responsibility to identify root cause.Present proposed solution in a clear and concise manner to leadership proficiently managed the processing of Marketplace, Medicare and Medicaid to insurance claims, ensuring accuracy and timeliness throughout the entire procedure. Triage unsupported que, to ensure cases appointed to reps timely determine coverage if any and the impact on the future coverage of the client Knowledge of ICD-9/10, Cpt coding, HPIC coding modifiers and DMHC regulation Proficient in marketplace,medicaid,and medicare practice enter all data into computer system for future referenceCentene, Tampa FL- Referral Specialist IOctober 2021-July 2022 Assesses caseload and realigns assignments to meet organizational needs. Spearheaded clerical intake data entry responsibilities, meticulously organizing various incoming documents such as Appeals, Grievances, Pharmacy requests, Claim Correspondence and Medical Records. Thrived in a dynamic, fast-paced environment by adeptly multitasking and delegating tasks, exhibiting strong decisions- making abilities in high-pressure situations acted as liaison between hospitals, physicians, health plans vendors and entered all data into the computer system for future reference. Initiate authorization request for outpatient and elective inpatient service in accordance with prior authorization list.Well Care, Tampa FL - Care coordinatorJanuary 2018-October 2021 Proficiently performed data entry tasks, ensuring accuracy and efficiency in processing crucial information Assists, completes and submits special projects and includes such as Appeals and Denials report or assignment to meet department functionality to support document management needs. assisted caseloads and realigns assignment to meet organizational needs Performed outbound calls to provide status to members for patient-in house/approved and denial Assisted with claims, intake, enrollment, and member services to resolve member and provider issues. Interacts with other departments to assist with special projects as directed by the supervisor.Well Care, Tampa FL - Intake SpecialistDecember 2012-January 2018 Operated company vehicle in the capacity of picking up and dropping off mail correspondence. Validate data in using data entry skill Assisted with customer service Assisted with special projects Tracker & Toolbox, Assisted with Appeals,and Grievance, PLP, and processes the claim projects. Produced reports and documents for the senior team. Sort mail and log and scanned mail to the supporting documention. Assisted caseloads and realigned assignments to meet organizational needs.EducationEastern Alamance High School Mebane NC General Studies High School diploma |
