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Click here or scroll down to respond to this candidate Candidate's Name
Lakeland,flEMAIL AVAILABLEPhone Number: PHONE NUMBER AVAILABLETo obtain employment with a company to contribute my experience in customer service, communication, and problem solving skills in a call center, retail, or front desk environment.Work ExperienceData ProcessorWipro- Tampa FlAug,2023 Mar,2024Duties Provide excellent customer service to clients seeking health care adviceAssist clients in understanding their health care options and making informed decisions Conduct outbound calls to clients to provide information and answer questions Analyze client needs and recommend appropriate health care solutions Maintain accurate and detailed records of client interactions and transactions through data entry Communicate effectively with clients, both verbally and in writing, in English or other multilingual abilitiesClaims RepresentativeUnitedhealth Group - Tampa, FLMay 2021 to July 2022 Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs) Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member Review and research incoming healthcare claims from members and providers (doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits) Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates) Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendanceCustomer Service RepresentativeMacy's Credit Service - Clearwater,FL October 2019 to February 2020 Answered inbound calls from customers inquiring about their account information. Updated customers' accounts and took payments over the phone. Assisted with resolving issues via telephone and making financial credit adjustments.Cashier/Prep-CookTampa Int'l Airport/Qdoba - Tampa,FL May 2019 to September 2019 Welcomed customers and helped determined their orders. Processed customers' order and entered into database. Assisted with food preparation of customers orders.Customer Service RepresentativeHealthnet - Tampa, FLOctober 2016 to January 2018 Received an average of 20 referrals a day for setting up appointments. Acted as liaison between the health provider and veteran patients scheduling appointments. Maintain cases of referral and follow-ups as necessary. Utilized medical billing and coding for scheduled procedures.Customer Service RepresentativeHealthplan Services - Tampa, FLFebruary 2015 to June 2016 Received inbound calls averaging 150 per day. Checked and informed eligibility and benefits for customers. Informed customers of treatment options and cost.. Conducted insurance eligibility verifications. Performed administrative duties, such as scanned and upload documents,Cashier/Sales AssociateWalmart - Tampa, FLAugust 2014 to January 2015 Responsible for friendly and timely service to customers. Handled cash and credit transactions utilizing sales register. Maintain daily count of register at the end of shift.Front Desk ClerkFlorida Memorial University -Tampa, FLAugust 2011 to June 201205/2010 - 01/2011 Welcomed and check-in customers for scheduled appointments or events. Received invoices and arranged documentation for payment Purchased supplies and materials for office.EducationFlorida Memorial University -Miami, FL May 2012High School DiplomaChamberlain High School - Tampa,FL May 2009Skills Skilled in providing information regarding products and services of the company. Knowledge of taking orders, compute charges and apply billing or payments. Experience in reviewing, updating or making changes to customers' accounts. Attentive to listen and respond to customers' needs and concerns. Knowledge of medical billing and coding procedures. CPT Coding Medical Records ICD-10 ICD-9 Chat Zendesk Data ProcessorCertifications and LicensesFood Handler Certification |
