Cornelia Smith
Phoenix,AZ
Summary
Professional with strong background in customer interactions and service solutions. Highly skilled in conflict resolution, communication, and problem-solving, ensuring customer satisfaction and loyalty. Effective team collaborator, adaptable to changing needs, and consistently focused on achieving results through efficient and empathetic service. Known for reliability and proactive approach to meeting customer and organizational goals.
Overview
1
1
Certification
6
6
years of professional experience
Work History
Certified Professional Coder
Optum / CSI Companies
Phoenix, Arizona
02.2022 - 02.2026
- Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations CMS 1500 and UB-04 Ambulatory Surgical Center claims
- Utilize and navigate across clinical software applications to assign medical codes or complete reviews
- Attain and/or maintain relevant professional certifications and continuing education seminars as required
- Provide resources and information to substantiate medical coding audit findings
- Reviewed medical records and assigned appropriate codes to diagnoses, treatments, and procedures, ensuring accurate representation of services provided.
- Manage multiple work demands simultaneously to maintain relevant productivity and turnaround times standards
- Conducted audits to verify coding accuracy and adherence to company standards, enhancing overall compliance.
- Resolved discrepancies in coding through detailed research and communication efforts.
- Finished assigned claims Excel worksheets before deadline
- Utilized electronic health record systems to input and manage coding data efficiently.
- Maintained up-to-date knowledge of industry trends and changes in coding regulations.
- Resolved claims edits by conducting research of claims systems and systemsedits to identify adjudication issues
- Understand and apply policies and procedures to multiple lines of business
Inbound Customer Service Representative
Medrisk
Phoenix, Arizona
06.2020 - 02.2022
- Collaborated with cross-functional teams to provide high quality solutions for medical providers.
- Established positive relationships with medical providers and patients through effective communication and listening skills.
- Processed physical therapy claims with medical providers over the phone in order for the patient to receive care
- Assisted patients over the phone with claims and insurance information
- Provided outstanding customer service and support to providers and patients, resolving inquiries efficiently and effectively.
- Prioritized workload according to urgency of requests or importance of customers' needs.
- Analyzed data to identify areas for improvement in the client experience process.
- Utilized problem-solving skills to resolve complex issues efficiently and effectively.
- Demonstrated ability to handle difficult situations professionally while maintaining composure.
- Created detailed reports and analysis on client feedback and satisfaction ratings.
- Provided excellent customer service by responding to inquiries, resolving customer complaints and addressing issues in a timely manner.
- Built trust with clients by being knowledgeable, understanding, helpful, responsive, and reliable.
- Ensured compliance of all applicable laws, regulations, standards, policies and procedures.
Education
High School Diploma -
Career Success High School
Phoenix, AZ04.2016
Skills
- Positive customer service
- Great communication
- Complaint resolution
- Professional telephone demeanor
- Attention to detail
- Reliable
- Multitasking
- Problem solving
- Teamwork
- Organization
- Active listening
- Critical thinking
- Data entry
- Administrative support
- Microsoft Office Suite
- Call center experience
- Computer proficiency
Personal Information
Title: Customer Service Representative
Certification
Certified Professional Coder
Timeline
Certified Professional Coder
Optum / CSI Companies
02.2022 - 02.2026
Inbound Customer Service Representative
Medrisk
06.2020 - 02.2022
High School Diploma -
Career Success High School