Seasoned professional with a diverse wealth of office administration, customer service and data management experience seeking an employment opportunity that utilizes my commitment to excellence and dynamic skill set. Exceptional organizational and ability to prioritize workflow coupled with my knack for readily adapting on the job make me a dynamic asset on any team.
PC: Windows and Internet, MS office Ste: Word, Excel, Outlook, General office equipment, Data Entry, Records Management
Recipient of the Commitment and Accountability Award
Documentation Specialist08/2012 to CurrentMedical Services of AmericaStatesville, NC
Develop and maintain working knowledge of current home care products (Respiratory, Oxygen and other DME equipment and services offered by the company.
Ability to create sales orders in Brighttree Software and confirm all open sales orders to release revenue on hold for 4 locations according to insurances allowable.
Verify Insurance eligibility and request Prior Authorizations for NC Tracks and other private payers.
Apply Medicare, Medicaid and other private Insurance guidelines.
Receive and respond to inbound telephone calls related to individual or group medical plans or claims.
Keep current on HIPPA regulations.
Resolve all customer inquiries fully and accurately according to established quality standards and criteria.
Apply excellent research skills demonstrating proficiency in utilizing multiple resources to identify the right answers/solutions.
Mail or route claims form and supporting documentation to various units for final processing.
Process an average of 50-60 inbound calls from cellular customer in regards to rate plan.
Troubleshoot and educate customers on different features/functions of wireless devices.
Account research for discrepancy in billing, contract date; upgrade eligibility and issues process correction.
Process adjustment up to $75 a day on accounts or submit request to adjustment department.
Process an average of 30-80 call from policy holders and insurance agencies.
Provide technical assistance to independent insurance agents with quotes, ACH management system.
Respond to billing questions, breakdown of payments, premium fees, research endorsements changes and accident points.
Educate policyholders and Independent agents on North Carolina Personal Auto guidelines and other general assistance.
Demonstrated the ability to process dictated personal auto loss claims of accidents from policyholders and claimants.
Assign claim adjusters and issue request for towing, car rentals and body shop recommendations.
Provided answers to questions about the process/ status of claims filed.
Download files and program electronic transaction credit card devices utilizing varies processors such as Visa net, Mapp, BB&T, Heartland Payment Systems and American Express.
Research merchants existing record file information for accuracy & ensure device was operational.
Demonstrate the ability to lead assigned team members on projects by specific guideline instructions.
Handle escalated file and terminal errors issues, inspected completed orders for quality and accuracy.
Purchase inventory of all reference materials, templates and manuals.
PFFS Care Specialist01/2010 to 01/2011Cigna HealthcareHigh Point, NC
Customer Care01/2008 to 01/2009Sprint/NextelCharlotte, NC
Personal Lines Care Consultant01/2006 to 01/2008GMAC InsuranceWinston Salem, NC
Sr. Programmer/QA Technician01/1999 to 01/2005Global Payment Systems, IncWinston Salem, NC
Associate of Applied Science: Business AdministrationForsyth Technical Community College
Additional coursework includes Medical Terminology, Records Management
Billing, Credit, Customer Service, Data Entry, Documentation, General office equipment, DME, Insurance, Inventory, Medical Terminology, Shipment, MS office Suite, Research, Sales, Technical assistance.