Quermauri Polk

• Verified accuracy of provider data entered into the system including tax ID numbers, NPI numbers, address changes .
• Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
• Processed a high volume of claims on a daily basis using established time frames.
• Ensured compliance with insurance company policies and procedures related to the processing of claims.
• Maintained up-to-date knowledge of health care industry trends and changes in regulations affecting medical billing processes.
• Worked collaboratively with providers' offices to ensure timely reimbursement on submitted claims by providing missing documentation or correcting errors that caused delays in payment processing.
• Investigated discrepancies in medical billing information such as incorrect codes or amounts due.
• Provided assistance in training new staff members as needed.
• Reviewed claims for accuracy before submitting for billing.
• Researched claim denials and appeals to determine appropriate resolution.
• Evaluated pending claims to identify and resolve problems blocking auto-adjudication.
• Used contract notes and processing manual to correctly apply group-specific classifications to claims.

Medical Customer Service

• Provided excellent customer service to resolve customer complaints in a timely manner.
• Remained calm and professional in stressful circumstances and effectively diffused tense situations.
• Escalated customer concerns, issues and requirements to supervisors for immediate rectification.
• Consulted with customers to resolve service and billing issues.
• Performed administrative tasks such as filing paperwork, updating databases and generating reports.
• Improved customer service wait times to mitigate complaints.

Personal Fitness/Boxing Trainer

• Provided motivation to help members stay committed to their health and wellness goals.
• Established rapport with clients by listening attentively to their concerns and responding promptly when assistance was required during workouts.
• Offered nutritional advice based on current dietary guidelines and scientific research.
• Educated members on the benefits of an active lifestyle through one-on-one consultations.
• Developed innovative strategies to engage members in physical activity and promote healthy habits.
• Collaborated with other trainers to ensure a safe workout environment for all gym patrons.

Licensed Boxer

• Studied fight films from previous opponents for tactical advantages.
• Reviewed video footage of past fights to gain insight into how to better approach future bouts.
• Collaborated with trainers and medical staff on injury prevention methods.
• Collaborated with coaching staff on conditioning drills designed to improve speed, agility and reflexes.
• Improved strength, agility, stamina and technique by pursuing learning opportunities and working hard.