Paul Parks
Mesquite,Texas
Summary
A dedicated Claims Processor with proven experience and an award-winning service. Strengths include a strong work ethic, problem solving and attention to detail. A team player that meets or exceeds company goals.
Overview
22
22
years of professional experience
Work History
Warehouse Associate
Amazon
12.2020 - Current
- ICQA – Associate – Forney Texas
- Identify & correct building defects
- Support Outbound & Inbound in their main functions
- Work on building projects that change our normal flow for improvements
- Picking – Dal 2 and Forney
- Picking customers for online order
- Packing Area – Dal 2
- Placing customers orders in various types of packages and boxes for shipment to customers
- Vendor Returns
- Loading Product being sent back vendors onto pallets or Gaylords being sent back to vendors
- Moving product into staging area for shipment back to vendors
- Picking products from bins for shipment back to vendors
- Loading pallets and Gaylords into trailers for shipment back to vendors
POS Analyst
LTCG (Long Term Care Group)
05.2019 - 11.2020
- Inputted POA (Power of Attorney), HIPPA authorization documents, Family and Friends authorization for in company database and Claims System
- Entered court documents regarding Guardian and Conservator ships in company database and claims systems
- Modified insureds policy to assist in lower their monthly premium
- Canceled insureds policy per written request
- Manually processed current benefit letters to policy holders and sent to be mailed out
- Used Dual-Monitor system
Customer Service Representative (Policy Owner Services)
Transamerica
08.2018 - 05.2019
- Inputted POA (Power of Attorney), HIPPA authorization documents, Family and Friends authorization form in company database and Claims System
- Entered court documents regarding Guardian and Conservator ships in company database and claims systems
- Modified insureds policy to assist in lower their monthly premium
- Canceled insureds policy per written request
- Manually processed current benefit letters to policy holders and sent to be mailed out
- Used Dual-Monitor system
Total loss processor (Auto)
Allstate (CONTRACT)
09.2017 - 10.2017
- Lien holder Payoffs regarding banks and other; institutions to obtain loan payoffs for vehicles declared total loss due to Hurricane damaged; processed paper work – to policy holders whose vehicles were determined to be a total loss
- Created Letters of Guarantees requests to Banks and other financial institutions that agreed with settlement for release of Liens and titles of vehicles
Prior Authorization Coordinator
Centene Corp/Superior Health
03.2015 - 07.2017
- Inbound calls from patients and providers setting service through Managed Texas Medicaid; setup new patients receiving services from Texas Medicaid
- Verified Patient eligibility for services; processed Patient transfers to new home health providers
- Communicated with patient and via phone and email
- Used Dual-Monitor System
Hospital biller
Health Scouts
04.2017 - 06.2017
- Inbound Calls from patients with balances remaining on their hospital bills; billed insurance on behalf of patients
- Called insurance companies for resolution of claims also edited claims for contractual errors
Customer Service Account Representative
Protection One/ADT
09.2015 - 04.2017
- Inbound calls from customers regarding alarm systems; processed payments on accounts /questions on accounts; Troubleshooter alarm issues; Setup service calls for systems
Customer Service Representative
Towers Watson/One Exchange
08.2014 - 03.2015
- Inbound calls from Medicare eligible members of group plans be transitioned off and into individual Medicare plans; assisted members with billing and reimbursement issue; documented information in company database for processing
Senior Care Representative/ Prior Authorization Representative
CVS/Caremark /Advanced PCS
08.2003 - 07.2014
- Inbound calls and Email request; Educated members on the drug plans and options
- Assisted in billing issues with pharmacy claims; Inputted Authorization requests from Medicaid Providers on specific drugs; Assisted Training Department with New Hire Class's
- Assisted in in rendering of new company brochure for the department
- Used Dual-Monitor Setup
- Pilot Team Lead – Dr
- Call Back
- Manage 4-person team calling Dr
- Offices regarding Prior Authorizations on Patient Prescriptions
- Assigned work based on work load that came in Error Data Base
- Kept records of attendance of team members
- Daily Reports to management on work load
Education
High School -
Woodrow Wilson High School
Dallas05.1978
Skills
- Active Learning
- Strong problem-solving skills
- Multi-tasking workload
- Quality Control Analysis
- Leadership Skills
- Active Listening
- Service Orientation
- Coordination of Benefits
- Troubleshooting
- Medical Terminology
- Auto Total Loss Claims
- MS Office
- ICD-9/10-CM and CPT Coding
- Dual-Monitor Setup
Toolsandtechnology
- Microsoft Office
- MS Outlook
- MS Excel
- Claims Central
- Get Now (Claims Database)
- NThrieve
- AS400
- Patient Records software (People Safe)
- HICA forms
- ICD-9 and ICD 10 and CPT coding
- Document rendering
- Dual-Monitor Setup
Timeline
Warehouse Associate
Amazon
12.2020 - Current
POS Analyst
LTCG (Long Term Care Group)
05.2019 - 11.2020
Customer Service Representative (Policy Owner Services)
Transamerica
08.2018 - 05.2019
Total loss processor (Auto)
Allstate (CONTRACT)
09.2017 - 10.2017
Hospital biller
Health Scouts
04.2017 - 06.2017
Customer Service Account Representative
Protection One/ADT
09.2015 - 04.2017
Prior Authorization Coordinator
Centene Corp/Superior Health
03.2015 - 07.2017
Customer Service Representative
Towers Watson/One Exchange
08.2014 - 03.2015
Senior Care Representative/ Prior Authorization Representative
CVS/Caremark /Advanced PCS
08.2003 - 07.2014
High School -
Woodrow Wilson High School
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