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  • CUSTOMER SERVICES REPRESENTATIVE FOR MEDICARE & MEDICAID
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CUSTOMER SERVICES REPRESENTATIVE FOR MEDICARE & MEDICAID Resume Example

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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 CurrentUNITED HEALTH CARECity , 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 08/2003SAINT VINCENT CATHOLIC MEDICAL CENTERCity , 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 .
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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

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