Customer Service Representative Resume Format For Students in Word Free Download -->

Customer Service Representative Resume Format For Students in Word Free Download

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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
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.

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
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

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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Neetu Singh is the founder of Resume Formats .Neetu Singh holds an Engineering degree in Computer Science with MBA Degree in Finance and Human Resource (HR). Currently she is running a Global Manpower Consultancy. Contact Her Here

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