Sample Template Example of Beautiful Excellent Professional Curriculum Vitae / Resume / CV Format with Career Objective, Job Profile & Work Experience for Freshers & Experienced in Word / Doc / Pdf Free Download
Education
Professional Experience
SRC, an Aetna Company, Columbia, SC 6/2005 – 3/2011
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Carlie
309
Roselle Drive, Columbia, SC 29001 (803) 920-9876 carlie@gmail.com
Objective
Telecommunications Systems Management position utilizing previous experience in customer service, problem solving, and technology skills.
Objective
Telecommunications Systems Management position utilizing previous experience in customer service, problem solving, and technology skills.
Education
Midlands Technical College, Columbia, SC
Associate in Applied Science, Telecommunications Systems
Management, December 2012
Associate in Business, Accounting, May 2002
Key Skills & Relevant Coursework
Key Skills & Relevant Coursework
Computer Systems Management (MS Windows NT OS), Cisco LAN
Concepts, Advanced Cisco Router Configuration, Hardware Basics, Network Design
Exploring CCNA certification
Computer
Skills
MS Office Suite, RIP, RIP2, OSPF, VLAN Routing, Router-On-A-Stick, VTP
MS Office Suite, RIP, RIP2, OSPF, VLAN Routing, Router-On-A-Stick, VTP
Professional Experience
SRC, an Aetna Company, Columbia, SC 6/2005 – 3/2011
Customer Service Representative, 2007 –
2011
·
Answered questions, explained
member’s rights and responsibilities, and resolved issues based on phone calls/letters from members,
providers, and plan sponsors.
·
Processed claim referrals, new
claim handoffs, nurse reviews, grievances and appeals.
·
Handled extensive file review
requests and assisted in preparation of complaint trend reports.
·
Responded to requests from
Aetna’s Law Document Center regarding litigation and lawsuits.
·
Assisted Client Managers by making
outbound calls to customers / providers and explaining escalation resolutions.
· Performed
reviews of member claim history to ensure accurate tracking of benefits
maximums and/or coinsurance / deductible.
Data
Entry Specialist, 2005 – 2007
· Sorted
documents, scanned letters and medical records received from doctors and
customers concerning various claims and posted on Lotus Notes for review.
· Compiled
mailings from medical reviewers and included forms to be completed by the
insured.
· Read
notes in LuminX and viewed images on Lotus Notes in order to provide required
information to send claims to medical reviewer for further processing.
· Processed
manager and medical reviewer requests for document research.
Companion Employment Services,
Columbia, SC 5/2004 – 12/2004
Accounts
Receivable Specialist – Temporary
· Processed
a minimum of 40 patient insurance claims per day by extracting medical records
from system, viewing and interpreting hospital records.
· Communicated
directly with patients; adjusted claim balances, resubmitted claims and
prepared appeals as needed.
· Conducted
research and communicated with insurance carriers to validate payment status.
· Corrected
and reviewed claims in various hospital computer systems.
· Interpreted
medical codes and allocated charges while managing time sensitivity and
confidentiality.
Carlie page 2
Professional
Experience (continued)
Companion Health Care, Columbia, SC 7/2002
– 3/2004
Billing
Specialist, Finance Department
· Prepared
/ reviewed billings for over 350 accounts in advance of monthly invoice
distribution.
· Resolved,
researched, and made system changes for all discrepancies within group billing,
including individual status and
classification corrections.
· Interpreted
proposals and contracts to accurately set up new group accounts.
· Verified
rate sheets, compiled impact information and ensured billing according to
contract stipulations.
· Prepared
and processed notice of insurance termination due to non-payment on a 15-day
cycle through the accounts receivable process.
· Processed
group insurance reinstatements as balances cleared and sent payments to cashier
for account updating.
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