Dedicated Customer Service professional with knowledge of service delivery and proven multitasking abilities. Committed to maintaining professional relationships to increase profitability and drive business results.
Overview
23
23
years of professional experience
Work History
Crew Member
Popeyes
11.2024 - Current
Customer service, taking and filling orders, maintain store cleanliness, and cash handling
House Cleaner
Self Employed Contractor
03.2022 - 03.2024
Clean customers house, grocery shop, cook and prepare dinner
Sr. Claims Examiner
Tegria
10.2021 - 03.2022
Process medical claims
Participate in weekly team meetings
Sr. Claims Examiner
The Jacobson Group
01.2020 - 02.2020
Assist in reduction of backlogged claims, process pended medical claims, verify and update claim information, complete outbound calls to obtain additional information, verify coordination of benefits, and maintain records, files, and documentation
Transplant Coordinator
Cigna
08.2011 - 12.2017
Process pended medical claims, verify and update claim information, completed outbound calls to request additional information, follow department guidelines and standards, verify coordination of benefits, adjust corrected claims, identify overpayments, request refund, maintain records, meet and exceed department production and quality standards
Sr. Claims Examiner
The Jacobson Group
02.2009 - 04.2009
Assist in reduction of backlogged claims, process pended medical claims, verify and update claim information, complete outbound calls to obtain additional information, verify coordination of benefits, and maintain records, files, and documentation
Sr. Claims Examiner
Trizetto Inc
06.2006 - 08.2008
Process pended medical claims, verify and update claim information, completed outbound calls to request additional information, follow department guidelines and standards, verify coordination of benefits, adjust corrected claims, identify overpayments, request refund, maintain records, meet and exceed department production and quality standard
Sr. Claims Examiner
Blue Cross Blue Shield of FL
12.2001 - 06.2006
Inbound/Outbound calls from members or providers, verify/update COB, follow departmental policies and procedures, create free form letters, maintain records/files/documentation as needed, and meet department production/quality levels
Education
Commercial Truck Driving Training -
MTC
Cape Girardeau, MO
10.2024
High School Diploma -
Mandarin High
Jacksonville, FL
05.1995
Skills
Customer service
Time management
Communication skills
Computer literacy
Medical Terminology
Microsoft Office
Microsoft Outlook
Excel
CPT Coding
ICD-9
ICD-10
HCPCS
Health Information Management
HIPAA
Timeline
Crew Member
Popeyes
11.2024 - Current
House Cleaner
Self Employed Contractor
03.2022 - 03.2024
Sr. Claims Examiner
Tegria
10.2021 - 03.2022
Sr. Claims Examiner
The Jacobson Group
01.2020 - 02.2020
Transplant Coordinator
Cigna
08.2011 - 12.2017
Sr. Claims Examiner
The Jacobson Group
02.2009 - 04.2009
Sr. Claims Examiner
Trizetto Inc
06.2006 - 08.2008
Sr. Claims Examiner
Blue Cross Blue Shield of FL
12.2001 - 06.2006
High School Diploma -
Mandarin High
Commercial Truck Driving Training -
MTC
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FRANKLYN ORAFUFRANKLYN ORAFU
Front of house team member at PopeyesFront of house team member at Popeyes