Summary
Overview
Work History
Education
Skills
Timeline
Generic

Carol Fox

Sealy,TX

Summary

Hardworking and passionate job seeker successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

  • Member of Second Baptist Church-Woodway Campus since August 2017.
  • Baptized at Second Baptist Church-Woodway Campus on August 5th, 2017.
  • Adult choir member from August 2017 to March 2020, returned November 2022 to current.
  • Volunteer Kid's Choir -1st thru 5th grade. January 2023 to current.
  • Volunteer Prayer Ministry.
  • Member of Fountain of Life Bible Study.
  • Co-Facilitator of Master Life class. January 2023 to current.
  • Choir Softball team member.

Spiritual Gifts:

  • Evangelism
  • Pastoring
  • Encouragement

Overview

36
36
years of professional experience

Work History

Client Support Specialist

Premier Medical Appeals
06.2020 - Current
  • Interacted with team members across departments to research and resolve customer issues.
  • Responded to all client inquiries and asked appropriate questions to facilitate resolution.
  • Delivered outstanding service to clients to not only maintain but to extend relationship for future business opportunities.
  • Cross-trained and provided backup support for organizational leadership.
  • Assist other staff members with questions and new hire training.
  • Root cause analysis of health insurance claim and authorization denials.
  • Phone calls to insurance companies to obtain information pertaining to claim denials, appeal information, and appeal status.
  • Complete and accurate documentation of all case files while maintaining HIPPAA compliance.
  • Utilize Microsoft Excel for 4 of our biggest client's monthly reports and invoicing.
  • Often assigned special projects and tasks that are detail oriented.

Advance EMT

Bayou City EMS
11.2019 - 03.2020
  • Ensured that all ambulance equipment, vehicle, and supplies are stocked, are within expiration dates, and working effectively.
  • Adhered to all rules and regulations regarding high quality patient care.
  • Documented each ambulance run including patient's vital signs and patient care provided in thorough and timely manner.
  • Drove ambulance according to all protocols, Texas state driving regulations, while maintaining patient and staff safety standards.

Advanced EMT / Dispatcher

Health Quest EMS
02.2017 - 10.2019
  • Maintained accurate patient records and documentation of treatments to enable tracking history and safeguard HIPPAA information.
  • Conducted equipment and vehicle checks to maintain continuous and safe operation.
  • Communicated with patients about pain, comfort, and needs during transportation and preliminary medical care.
  • Assisted with lifting and moving patients.
  • Dispatched wheelchair vans and ambulances to various locations based on need.
  • Coordinated pick up times and drop off times of patients.
  • Answered over 60 incoming calls per day in professional and timely manner.
  • Documented all calls and dispatched according to location and mode of transportation needed.
  • Maintained levelheadedness and efficiency in high-pressure situations, effectively prioritizing tasks to save staff and patient wait times.

Claims Trainer

Prudential Healthcare / Aetna Healthcare
08.1987 - 01.2000

Worked independently with minimal supervision, setting priorities and demonstrating excellent project management skills.

  • Led large-scale, high-impact projects from start to finish with minimal or no supervision to achieve specific training goals.
  • Trained and mentored over 400 new personnel hired to fulfill various roles.
  • Created training material for and trained staff from all departments in 4 sessions, each session included about 200 people.
  • Analyzed and evaluated training effectiveness and program outcomes.
  • Coordinated training schedules across sites with supervisors and managers to optimize training initiatives and work-flow management
  • Developed lesson plans, instructional materials and written practice tests for claim processing and new hire training courses.
  • Utilized Microsoft Power Point to make presentations to be used during training classes.
  • Wrote and updated training manuals for claim processing guidelines according to strict company guidelines and protocols.
  • Reviewed and validated quarterly claim audits, successfully appealed audit errors, and made suggestions for training on based on audit findings.
  • Won national 2nd prize for outstanding customer service. My coworker was not able to travel due to illness. I volunteered to travel in her place. Reward of recognition: personal computer and printer.

Education

No Degree - Advanced EMT Certificate

Houston Community College
Houston, TX
12.2019

No Degree - Entrepreneurship

Houston Community College
Houston, TX
12.2017

High School Diploma -

Hanford High School
Richland, WA
01.1977

Skills

  • Client Relationship Building
  • Interpersonal and Written Communication
  • Knowledgeable in Microsoft Word, Excel, and Power Point
  • Account Management
  • Report Creation
  • Inbound Call Management
  • Computer Skills
  • Customer Data Confidentiality
  • Document and Records Management
  • Strong Analytical and Problem Solving Skills
  • Work Prioritization
  • Calm and Professional Under Pressure

Timeline

Client Support Specialist

Premier Medical Appeals
06.2020 - Current

Advance EMT

Bayou City EMS
11.2019 - 03.2020

Advanced EMT / Dispatcher

Health Quest EMS
02.2017 - 10.2019

Claims Trainer

Prudential Healthcare / Aetna Healthcare
08.1987 - 01.2000

No Degree - Advanced EMT Certificate

Houston Community College

No Degree - Entrepreneurship

Houston Community College

High School Diploma -

Hanford High School
Carol Fox