claims benefit specialist Resumes in US-South Carolina-Columbia: juvockia

claims benefit specialist Resume

Contact Candidate

Name:

juvockia

Location:

US-South Carolina-Columbia

Experience:

Willing to Relocate:

Willing to Travel:

Most Recent Job Title:

claims benefit specialist

Personal Website:

Objective:

To obtain a position within client relations and technology repair that would give me the opportunity to demonstrate my outstanding leadership and personable skills.

Resume Text:

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able ensuring accurate and timely claim processing service
2003- 2007 Blue Cross Blue Shield of South Carolina Columbia, SC
Member Service Representative
 Researched and responded to telephone inquiries according to desk procedures
 Ensured that contract standards and objectives for telephone timeliness, productivity and quality were met.
 Identified incorrectly processed claims and completes the adjustment and reprocessing action according to department guidelines.

Professional Review Analyst
 Manage high priority accounts and case managements
 Analyze delinquent and closed patient’s accounts
 Respond to complex customer service inquiries
 Manage the monthly reports to be reviewed by the prime contractors
 Review medical records and forward for processing
 DB2 Certified
 DRG Grouping and research
 Research and process inpatient claims
 Correspond with prime contractor

2006–2007 Grand Strand Center Against Rape Crisis Myrtle Beach, SC
Volunteer / Internship
 Mentor victims that have been in a major crisis
 Provide victims with helpful information
 Assure patients have a safe place to reside after the crisis
2001- 2003 NIKE, INC Myrtle Beach , SC
Sales/ Cashier
 Assist customers with checkout
 Open and close department
 Perform normal closing procedures
Education
2005- 2007 Horry Georgetown Technical College Myrtle Beach, SC
Human Services/ Minor Computer Programming
2007 – present Limestone College Gaffney, SC
B. S. Computer Information Management/Web Development

Awards/Accomplishments: Horry-Georgetown Technical College Human Services Club (Club awarded: National Organization Human Services Community Service Award 2005 and Alpha Nu Sigma Award for Community Service and Leadership 2005), Participated in homeless Count 2005 and 2007, Salvation Army Boys and Girls Club, Fostering Hope (Horry County children in foster care).

References Available upon request

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