Customer Service, Medical Resume

Desired Industry: Customer Service/Technical Support	SpiderID: 8412
Desired Job Location: Atlanta, Georgia	Date Posted: 8/23/2006
Type of Position: Full-Time Permanent	Availability Date: 08/22/2006
Desired Wage: 29000
	U.S. Work Authorization: Yes
Job Level: Experienced with over 2 years experience	Willing to Travel: Yes, Less Than 25%
Highest Degree Attained: High School/Equivalent	Willing to Relocate: Yes

Objective:
To obtain a career in which I may work with and for the public. This opportunity should afford avenues in which one may acquire new, and enhance currently possessed skills. Also, the advantage of working within the company to ensure its growth and advancement

Experience:
6/2005 to 11/2005 D F C S Jonesboro, Ga.
Case Management Assistant
Examine and appropriate documents
Ensure client cases are updated accurately with newly implemented actions
Organize and work with detailed office or warehouse records, using computers to enter, access, search and retrieve data

7/2004 to 12/2004 LaVista Resources Group Atlanta, Ga
Patient Billing
Review insurance policy to determine coverage ,using
Computers to enter, access, search and retrieve data
Investigate, evaluate and settle claims
Contact claimants, doctors, medical specialists, or employers to get additional information
Examine questionable claims to
determine whether to authorize payments

2001 to 2003 Cape Fear Valley Hospital Fayetteville, NC
Patient Registration/Billing
Review insurance policy to determine coverage
Organize and work with detailed office or warehouse records, using computers to enter, access, search and retrieve data.
Record patients' medical information and vital signs

1998 to 2001 Healthcare Resources Group Concord, CA
Claims Examiner
Investigate, evaluate and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio
Adjust reserves and provide reserve recommendations to ensure reserving activities consistent
with corporate policies
Operated computer terminal to input and retrieve data

1996 to 1999 Sterling Claims Oakland, CA
Claims/Patient Registration
Contact and/or interview claimants, doctors, medical specialists, or employers to get additional information
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments
Prepare and review insurance-claim forms and related documents for completeness.
Review settled insurance claims to determine that payments and settlements have been made in accordance with company practices and procedures

1994 to 1996 Telecommunications Incorporated Livermore, CA
Entertainment Consultant/CSR
Provided technical support, implemented procedures and detail problem solving
Scheduled appointments and gave information to callers
Assisted customers by telephone to answer inquiries and complaints pertaining to bills, customer deposits and accounts

Education:
1986 Diploma College Prep Oakland Technical High School Oakland, CA

Skills:
Proficient in hospital, professional and DME Claims
ICD 9 and HCPCS
Proficient in Microsoft Word, Excel, PowerPoint, WordPerfect, Lotus 1-2-3, 10-key and Typing
Demonstrates effective presentation, communication and negotiable skills, while providing excellent customer service
Novell, Horizon, Star, SMS, Sunrise, Medic, IMF, IDX, Smart Link Systems
UNIX System, Tristar,AS400, Mediwork, and UBH Systems

Reference:
Available Upon Request

Candidate Contact Information:

Name: Daphne Carson
Street: -	Phone: 4045088232
City: Stone Mountain	Fax: -
State: Georgia
Zip: 30083
Web Site: