Ability to multi-task with efficiency and accuracy in a high paced environment. Excellent computer skills, knowledge of Microsoft Office software 10+ years of Customer Service experience analyzing and solving customer issues. Ability to handle multiple work assignments, set priorities and meet deadlines. Knowledge of medical terminology and CPT codes. Typing 55 - 60 wpm
Blue Cross Blue Shield of TexasAugust 2013 to CurrentClaims Examiner Richardson, TX
Process complex claims requiring further investigation.
Resolve pended claims.
Research participant invoices to resolve billing errors.
Make outbound calls to Physicians to rectify pending claims.
State Farm InsuranceFebruary 2013 to August 2013Agency/Sales Resource Representative Irving, TX
Call Center environment.
Provided professional support to State Farm Agents and Agents staff.
Assisted agents with Sales Force program.
Assisted with contract questions and password resets.
HumanaJanuary 2012 to August 2012Customer Care Specialist Tampa, FL
Worked in a fast paced environment and handled a constant volume of phone inquiries.
Assisted providers/Members with benefit verification and coverage.
Assisted with Claims/appeals status inquiries.
Blue Cross Blue Shield of TexasDecember 2002 to January 2010Account/Membership Representative III Richardson, TX
Supported account set-up and maintenance processes for new/existing accounts.
After confirming all required documents were submitted, processed information and released to underwriter for approval.
Released initial ID cards, payments and bill once group had been approved.
Small Business segment experience.
Hillsborough High SchoolDiplomaTampa, FL
El Centro CollegeCertificate: Cisco Network InternDallas, TX
Richland CollegeCertificate: Managing & Maintaining ComputersRichardson, TX