Claims Support Specialist Resume

PROFILE

Experienced customer service and knowledge of medical and disability terminology with excellent care taking, communications and assessment skills. Hard working team player that is passionate about achieving results satisfying to all parties involved. Demonstrated office and organizational skills. Diversified experience in healthcare policies and practices. Proficient in Lotus 123, Word Perfect 4.0 and Windows 95 T-Mate.

PROFESSIONAL EXPERIENCE

Confidential, Hartford, CT
2010-present

Personal care (non-medical)

Stand-by assist in bathing, grooming and dressing;
Provide fellowship such as conversation, reading, letter writing

assist with activity, or accompany client to social activity.

Household tasks required for personal care:

Prepare meals, wash dishes, clean floor after meals;

Make bed, change linens, clean bathroom after bath;
Laundry.

General household tasks (not related to personal care)
Dust furniture;
Vacuum floors, wash floors/windows;
Clean refrigerator, clean oven.
Maintains documentation of services if requested.

Confidential, Hartford, CT C.R.T., Hartford, CT
Intake Worker 2003-2008
Obtained necessary information from clients for energy department that involved dealing with seasonal issues. Answered telephone calls, filing, entered client information into system and scheduled appointments for clients.

Confidential, Hartford, CT 2001 - 2003
Claims Coding Analyst 2001-2003
Responsible for coded claims with benefits information for processing. Successfully identified members who have secondary insurance plans and is familiar with process for identifying primary and secondary policies. Observed policies and procedure related to confidentiality of medical records and release of information and retention of records. Maintained knowledge of procedures and diagnostic codes and performed exceptional customer service.

Confidential, Hartford, CT 1998-2000

Claims Support Specialist 1998-2000

Responsible for documenting cases into T-Mate system, duties included making phone calls, handling correspondence outgoing and incoming with regard to handling claims determinations and referrals to Worker’s Compensation case manager and Disability Manager. Input claims that were re-routed to reporting center including input of Medicare bills.

EDUCATION

Certificate of Completion for Computer Skills

Diploma

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