Job Application Cover Letter

AREA OF EXPERTISE

· Administrative professional offering 10 years of experience of Office Administration and Customers Service skills. Highly organized, efficient and skilled in a variety of office support responsibilities, including:

· Knowledge of data entry/retrieval · Knowledge of MediSoft · Proficiency in medical terminology · Ability to successfully complete multiple tasks simultaneously · Organize and prioritize work, work independently · Excellent verbal communication in person and on telephone · Problem-solving skills

· Proficiency in MS Word, and Excel · Excellent internal and external customer service · Work collaboratively with others in various office setting · Ability to operate office machines: fax, telephone, computer, and scanner · Recipient of several outstanding customers service bonuses totally over $2,000

Anthem Blue Cross and Blue Shield, Columbus, GA

Customer Service Representative , II 12/2013 – Present

· Receives inbound call from provider for claim status.

· Research provider claims to provide claim adjudication for payment details, denial reasons, and rejection codes.

· Reviewed corrected claims and routed to the applicable department to be reprocessed for adjustments.

· Submitted inquiries to member home plans regarding denials and benefits information.

· Send provider correspondence regarding claim status, provider contracts, member benefits, and denial reasons.

· Research provider contract for pricing of claim allowable.

· Upload providers appeal for reconsideration of claims.

· Reviewed and research provider’s National Provider Identifier to determine timely filing, networks status and effectives dates.

· Validate provider claim via verifying HIPAA.

· Fax Explanation of Benefits to provider and discussed recoupment information.

Magnolia Manor Nursing Home via Accountemps, Americus, GA

Insurance Clerk, 06/2013 – 07/2013

· Filed UB-04 claims, aged account claims and processed insurance checks for Medicare, Medicaid, Tricare, CHAMPVA and private insurances for data entry for five major nursing centers.

· Used AmericanhealthTech or Long Term Care system to review patient’s information and update patient’s data.

· Processed therapy billing report for payment and verified validation of pre-certification numbers and updated information in system for five major nursing centers.

· Monitored excel cash flow report spreadsheet by units number time the dollars amount per unit and submitted information to office manager.

· Filed for five major nursing centers.

· Read EOB’s and Remit Advice for denied and adjustment claims; sorted insurance documentation for follow up to be worked.

Trinity Case Management, Columbus, GA

Case Manager/Office Assistant, 01/2013 – 04/2013

· Assessed 38 members through phone and face to face interviews and determined their eligibility for comprehensive service plan.

· Collaborated with physician and healthcare members regarding plan of care and followed member privacy guidelines in according to HIPPA.

· Completed required members documentations, scanned and purged medical records by following proper procedures.

· Routinely updated demographic information on members’ charts as needed.

· Obtained member signature for enrollment in SOURCE and routinely updated member’s status and progress and conducted any needed reviews with members to determine appropriate level of care in a timely manner.

· Reviewed/filed medical records

· Documented members personals data, diagnosis, and medications

· Attended provider’s meeting monthly via conference calls and face-to-face to discuss member’s progress.

Blue Cross Blue Shield via Aerotex, Columbus, GA

Pharmacy Locator, 10/2011to 01/ 2012

· Resolved inquiries in high volume call center while located and provided name of pharmacies

· Aid and assisted customers with filling, picking up, and transferring prescriptions.

· Ensured customer’s information was kept confidential and followed HIPPA Policies and guideline

· Recipient of outstanding customer service.

Road America, Columbus, Georgia

Assistance Coordinator, 05/2005-05/2011

· Demonstrated ability to log all notes and follow up information accurately

· Hands-on experience in receiving inbound and making outbound for customer support.

· Proficiency in using more than one screen at a time, softphone, and headset.

· Resolved an average of 200 inquiries weekly and consistently met performance benchmarks in all areas (speed, accuracy, volume).

· Handled customer inquiries and complaints in high-volume call center for stranded motorist.

· Earned 100% marks in all categories including communication skills, listening skills, problem resolution and politeness.

· Commended for initiative, enthusiasm, tenacity, persuasiveness, intense customer focus and dependability in performance evaluations.

Ferrellgas Company, Dawson, Georgia Customer Service Specialist 07/2005-03/2006

· Managed office responsibilities such as: opened and closed office, order office supplies, and uploaded end of the month reports.

· Handled a range of administrative support and office management functions for clients including processing application for new accounts.

· Answered multi-lined telephone/ transferred calls to appropriate extensions

· Handled accounts payable and petty cash and made daily deposit of $10,000 or more.

· Followed up with customers for collection

· Picked up mail daily and distributed to the appropriate department

Bachelor Degree University of Phoenix, Columbus, GA

Health Administration/Health Management

Diploma, Virginia College, Columbus, GA

Medical Billing and Coding

Certificate, Columbus Technical College, Columbus, GA

Office Management

CERTIFICATION

Page 2

Certified Professional Coding

MEMBERSHIP

Rebecca Harpe Page 2

American Academy of Professional Coder