Nyia Vang
Sacramento,CA
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
15
15
years of professional experience
Work History
Claim Adjudication Specialist
Manpower
10.2021 - Current
- Processes UI claims under applicable laws, determines eligibility for UI, collaborate with parties to resolve issues, reviews contested claims for redetermination
- Manages time sensitive and confidential information
- Collaborate with peers and leaders with issues/concerns
- In/Outbound calls to claimants/employers/3rd party vendors to verify time sensitive information
- Engaging in active listening with callers, confirming or clarifying information and diffusing angry clients, as needed
- Utilizing software, databases, scripts, and tools appropriately
- Assists employers with completing and submitting reports; reviews and processes employer-submitted reports; and provides account maintenance
- Investigates improper benefit payment and UI applications; refers callers to anti-fraud and identity theft resources; and prepares cases for prosecution
- Prepare UI case materials for review
- Maintain files and close cases according to established procedures
- Identify trends and recommend corrective measures.
Complex Authorization Specialist
TriWest HealthCare Alliance
04.2017 - 03.2021
- Created new authorization for medical care by abstracting information from patient medical records
- Analyzed policy guideline and regulations to determine if authorizations needed to be updated or required provider review
- Communicated with provider offices by phone or email to obtain additional information on authorization request
- Audited and updated authorization to meet minimum guidelines
- Analyze incoming request from the VA and task to appropriate departments to be completed
- Trained new employees as requested
- Made outgoing calls to veterans to schedule appointments
- Processed medical claims for payments
Appointing & Authorization Agent
Kelly Services, INC-Health Net Federal Services
10.2015 - 12.2016
- Reviewed and entered complex authorizations and referrals from VA and providers
- Provides initial data entry related to potential quality issues
- Ensured accurate data entry and completion of authorizations
- Reviewed data, medical records, and referral/authorization forms
- Requested appropriate records and processed initial review of those records
Service Support Agent
Dealer Track Technologies
08.2014 - 10.2015
- Managed inbound calls from clients and customers
- Management and maintenance of vehicle titles
- Responded to client inquires on vehicle titling and registration
- Contacted various dealers, state motor vehicles agencies, and customers to obtain vehicle title due to requested changes
- Processed application for duplicate vehicle titles and processed changes to vehicle titles
Service Support Agent
Volt Workforce Solutions
04.2014 - 08.2014
- Managed inbound calls from clients and customers
- Management and maintenance of vehicle titles
- Responded to client inquires on vehicle titling and registration
- Contacted various dealers, state motor vehicles agencies, and customers to obtain vehicle title due to requested changes
- Processed application for duplicate vehicle titles and process changes to vehicle titles
Customer Service Representative
Verizon Wireless
06.2003 - 02.2011
- Managed on average 65 to 75 calls per day
- Tier 1 troubleshoots service and equipment concerns
- Researched and resolved billing inquiries
- Resolved customer inquiries on service, rates, adjustments, and policy issues
- Established update and retrieved customer service data
Education
High School Diploma -
Grant Union High School
Skills
- Organizational Skills
- Strong Typing Skills (50 WPM)
- Excellent phone etiquette
- Professional Customer Service
- MS Office 2007, 2010, Outlook
- Call Center Service Operations
- Knowledge of clerical methods
- Excellent Work Ethic
- Problem Solving
- Adaptability
- Goal-oriented
- Production Goals
- Complex Coverage Issues
- Settlement Management
Timeline
Claim Adjudication Specialist
Manpower
10.2021 - Current
Complex Authorization Specialist
TriWest HealthCare Alliance
04.2017 - 03.2021
Appointing & Authorization Agent
Kelly Services, INC-Health Net Federal Services
10.2015 - 12.2016
Service Support Agent
Dealer Track Technologies
08.2014 - 10.2015
Service Support Agent
Volt Workforce Solutions
04.2014 - 08.2014
Customer Service Representative
Verizon Wireless
06.2003 - 02.2011
High School Diploma -
Grant Union High School
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