LiveCareer-Resume

complaint analyst resume example with 12+ years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
Professional Summary

Knowledgeable of the Medicare standards regarding physicians, hospitals and durable medical equipment. Experienced with some medical coding.

I have a strong work ethic and positive attitude. Highly effective in fast-paced work environments.

Skill Highlights
  • Exercises good judgment
  • Team player with positive attitude
  • Strong work ethic
  • Data collection and analysis
  • Exceptional organizational skills
  • Creative problem solver
  • Attention to detail
  • Exceptional customer service
  • Microsoft Office, Excel, PowerPoint proficiency
  • Computer proficient
  • Telnet
  • Business Objects
  • Fraud Investigation Database
  • Knowledge of Medicare


Professional Experience
Complaint Analyst, 09/2011 - Current
Pace Life Sciences South New Berlin, NY,

Answered customers’ questions and addressed problems and complaints via phone.

Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.

Performed research by completing reports and information over the Internet.

Completed desk level reviews of various documents.

Request medical records from suppliers and providers regarding the beneficiary's complaints.

Request voluntary overpayments back to the Medicare Trust Fund.

Initiated the amount of $57,830.58 to be returned back to the Medicare Trust Fund from both suppliers for the years 2012 and 2013.

Became the Quality Control designee in November 2013. Would verify the information and documentation was organized and entered correctly in the systems.


Support Clerk, 08/2009 - 09/2011
Insurance Administrative Solutions Clearwater, FL,

Handled incoming and outgoing correspondence, including mail, email and faxes.

Accurately handled confidential materials.

Organized files, spreadsheets, and scanned documents to be sent to a separate facility.

Perform basic research using various systems.

Maintained and uploaded confidential information into various systems.


Cashier, 09/2008 - 08/2009
Chick-Fil-A Columbus, OH,

Maintained knowledge of current promotions, policies regarding payment and exchanges, and security practices.

Operated a cash register to process cash, check and credit card transactions.

Replenished floor stock and processed shipments to ensure product availability for customers.


Desk Associate/Cashier, 06/2008 - 08/2009
Ann Taylor Store City, STATE,

Maintained knowledge of current promotions, policies regarding payment and exchanges, and security practices.

Recommended merchandise based on customer needs.

Operated a cash register to process cash, check and credit card transactions.

Replenished floor stock and processed shipments to ensure product availability for customers.


Education and Training
High School Diploma: , Expected in 2005
-
La Salle High School - Miami, Florida
GPA:
Status -

Member of Art and Drama Club

: Psychology, Expected in
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Miami Dade College - Miami, Fl
GPA:
Status -
: , Expected in
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Centers for Medicare & Medicaid Services Training - Miramar, FL
GPA:
Status -

CMS Information Systems Security and Privacy Awareness Training. This has been completed yearly since 2009.

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Resume Overview

School Attended

  • La Salle High School
  • Miami Dade College
  • Centers for Medicare & Medicaid Services Training

Job Titles Held:

  • Complaint Analyst
  • Support Clerk
  • Cashier
  • Desk Associate/Cashier

Degrees

  • High School Diploma

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