Charles Palin
Jacksonville,FL
Summary
With over 20 years of proven experience in personnel management, customer service, fraud investigations, training, and sales, I am a productive and reliable professional. Actively seeking a challenging career with a progressive organization that values my skills and abilities. Eager to contribute my expertise to an environment that offers opportunities for growth and development.
Overview
22
22
years of professional experience
Work History
Discrepancy Analyst
Parallon
08.2019 - Current
- Investigate and analyze government discrepancy reports to determine type of financial discrepancies and assign appropriate reason codes for insurance follow up process
- Review and analyze healthcare benefits and analyze regulatory policies
- Correct contractual adjustments on accounts and make corrections on nonpayment related discrepancies
- Verify the accuracy of calculated discounts in analyzing discrepancies to determine root cause and resolution steps
- Utilize BOBJ (Business Objects analysis tool) to retrieve and review reporting
- Serve as Subject Matter Expert in Artiva, Onbase and Concuity applications
- Research all discrepancies to determine root cause, find resolution and clear discrepancy
- Overcome objections that prevent payment of the claim
- Identify and communicate trends to management, including those that might be appropriate for the resolution process
- Knowledge of medical terminology, ICD-9, and ICD-10
- Utilize effective documentation standards that support a strong historical record of actions taken on the account
Provider Servicing and Benefits Analyst
Novitas Solutions
01.2019 - 07.2019
- Processed submitted provider applications
- Obtained additional information via telephone or in writing as needed
- Determined if both state and federal regulatory requirements are met
- Reviewed supporting documentation for adequacy; make final determination/recommendation on application
- Created enrollment records in applicable system(s)
- Reviewed local medical coverage and national medical coverage policies in order to troubleshoot reasons for claim denials and reductions
- Established Electronic Funds Transfer (EFT) of provider Medicare payments
- Researched and responded to application specific or general provider enrollment written inquiries
Customer Service Rep and Sales Team Lead
Plum Choice/Cox Communications
03.2013 - 08.2015
- Directly supervised and coordinated the activity of team members engaged in marketing and project management while ensuring that developments are completed in a timely and efficient manner to achieve operational goals
- Worked directly with Human Resources to manage employee records and reports
- Monitored calls for team members to identify skill gaps, diagnose behavioral drivers, and coach to improve, driving one call resolution and meeting key performance metrics
- Responsible for projects that impacted and influenced the customer experience
- Assisted in establishing employee schedules, monitoring schedule adherence and reporting attendance outliers
- Implemented solutions which fostered a positive work environment, teamwork, growth, and high morale within the department
- Assisted representatives with difficult and complex customer interactions which require research and problem resolution to preserve customer relationship
- Responsible for personnel development to support business needs, including onboarding, coaching, individual action plans and annual skills appraisals
Customer Resolution Specialist
AT&T
09.2008 - 07.2011
- Assisted Senior Management in the design and implementation of training programs
- Facilitated ongoing aptitude testing and led procedural training to certify employee compliance
- Served as a Help Desk Associate for newly hired Customer Service Associates in need of call handling assistance
- Resolved issues related to internet connections for clients
- Facilitated training classes for new hire Customer Service Associates and internal transfers
- Coached and developed Customer Service Representatives within the business to enhance service skills
- Created and maintained training handbooks to increase team's process and product knowledge, enabling higher levels of productivity and efficiency
Mortgage Specialist
Washington Mutual
12.2007 - 08.2008
Dealer Financial Services Representative
Bank of America
07.2006 - 11.2007
Customer Service Manager
Convergys
03.2003 - 06.2006
Education
Doctorate Degree - Education
Jacksonville Baptist Theological Seminary
Jacksonville, FL09.2024
Skills
- Audit compliance
- Spreadsheet proficiency
- Quantitative skills
- Teamwork
- Problem-solving
- Time management
- Attention to detail
- Financial and operational reporting
- Risk assessment
- Continuous improvement
- Performance analysis
- Compiling data
- Quality evaluation
References
Will be provided upon request
Timeline
Discrepancy Analyst
Parallon
08.2019 - Current
Provider Servicing and Benefits Analyst
Novitas Solutions
01.2019 - 07.2019
Customer Service Rep and Sales Team Lead
Plum Choice/Cox Communications
03.2013 - 08.2015
Customer Resolution Specialist
AT&T
09.2008 - 07.2011
Mortgage Specialist
Washington Mutual
12.2007 - 08.2008
Dealer Financial Services Representative
Bank of America
07.2006 - 11.2007
Customer Service Manager
Convergys
03.2003 - 06.2006
Doctorate Degree - Education
Jacksonville Baptist Theological Seminary
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