CUSTOMER SERVICES REPRESENTATIVE FOR MEDICARE & MEDICAID Resume Example Company Name

CUSTOMER SERVICES REPRESENTATIVE FOR MEDICARE & MEDICAID

Professional Profile

Healthcare professional with 25 years hands-on experience in fast-paced environment into the Medical and Insurance field. Accountable and Responsible with a strong focus on patient wellness and education. Excellent working knowledge of Computers Application including Microsoft Office Windows, Multiple Telephone line, Excel andTyping.

Skill Highlights

High customer service standards
Employee relations specialist
Accountability
Knowledge of Medicaid statutes and regulations

Service solutions expert
Conflict resolution proficiency
Planning and development
Patience and self-discipline

Work Experience

CUSTOMER SERVICES REPRESENTATIVE FOR MEDICARE & MEDICAID02/2005 to CurrentCompany NameCity, State

CRT usage to retrieve membership and claims information.
Claims processing and educated member and providers on there explanation of benefits and provider remittance advices.
Made reasonable procedure exceptions to accommodate unusual customer requests.
Provided accurate and appropriate information in response to customer inquiries.
Worked with upper management to ensure appropriate changes were made to improve customer satisfaction.
Built customer loyalty by placing follow-up calls for customers who reported product issues.
inform and educated members on there billing/invoicing set up and billing payment procedures.

SOCIAL WORKER & CASE MANANGER ASSISTANCE06/1999 to 08/2003Company NameCity, State

Assisted 20 Case Manager and Social worker on a daily basis.
Daily correspondence with proper placement for several nursing home and community agency for patient safety in a timely manor.
Coordinated nursing department activities to ensure availability of appropriate clinical and support staff for resident care.
Established and maintained systems that safely met residents' needs.
Developed a system of staff communication that ensured proper implementation of treatment plans and comprehensive patient care.
Transcription and maintained doctors orders.
Organized and converted hospital lunchroom into a make shift emergency room during the 2003 blackout.

Education and Training

OCCUPATIONAL ASSOCIATES DEGREE: RADIOLOGY TECHNOLOGY2009MEDVANCE INSTITUTECity, State, BROWARD

Two years of Radiological Program and Hands on Clinical Training at

Imperial Point Hospital , Emergency Room and OR.
Holy Cross Health Plex, Out patient facility
7 Avenue Clinic an Affiliate of Broward General Hospital .

Resume Overview

School Attended

MEDVANCE INSTITUTE

Job Titles Held:

CUSTOMER SERVICES REPRESENTATIVE FOR MEDICARE & MEDICAID
SOCIAL WORKER & CASE MANANGER ASSISTANCE

Degrees

OCCUPATIONAL ASSOCIATES DEGREE : RADIOLOGY TECHNOLOGY 2009

CUSTOMER SERVICES REPRESENTATIVE FOR MEDICARE & MEDICAID Resume Example

Resume Score: 65%

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