
Dedicated professional with extensive experience in customer service and claims processing. Proven ability to handle high volumes of claims efficiently while providing excellent telephonic support. Committed to training new staff and maintaining high standards of service.
Responsible for processing medical claims on a production rate of 25 claims per hour with excellent quality. Provide telephonic support for customers calling with general questions regarding eligibility, benefits, referral process, physicians/providers and members. Answers calls from the members and providers with a speed to answer rate of 2.35 seconds with no abandon rate. Responsible for training of all new Customer Service Representatives in a timely manner.
Composed and typed routine letters, memoranda's, prepared a variety of reports, minutes of meetings, scientific or technical material, numerical data, charts and forms. Received and screened all visitors and telephone calls, took messages, scheduled appointments for professionals and or management. Sorted, opened and distributed incoming mail to the staff and associates incoming correspondence files or related materials needed for meetings.
9 years of experience processing medical and dental claims for several accounts with various benefit levels and plan provisions Above average knowledge of state and federal laws as it applies to claims administration Medical terminology, Medicare, Medicaid, ICD-9, CPT-4 Coding, HMO, PPO, POS, Capitated electronic claims, COB, and 10-key by touch