Samantha Tuan Bun
Las Vegas,NV
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
20
20
years of professional experience
Work History
Large Group Specialty Department
Elevance Health
Las Vegas, NV
05.2023 - Current
- Processes credit card payments and posts payment to the appropriate account
- Other duties and projects will be assigned as needed
- Answer telephone billing inquiries from customers, outside sources and in-house personnel
- Perform various follow up activities including telephone calls, appeals, letters and utilizes payer websites to achieve timely resolution
- Partner with the appropriate staff and departments to ensure optimal working relationships
- Prepare refund requests or forward to appropriate person depending on department/area
- Review accounts to be considered for write off due to exhausted follow up efforts and time limits
- Review accounts with balances that were a result of incorrect payer payments/adjustments
- Ensure compliance with quality assurance and productivity department goals specific to main job responsibilities for each area of the business office
- Maintain skill proficiency, including improvement where deemed necessary, and upgrading any additional or new skills on the appropriate position skills list
- Assist customers to make health care decisions by carefully matching customers with the optimal products and services.
Pua Adjudicator, Eligibility Benefits
AppleOne
Las Vegas, NV
02.2021 - 05.2023
- Assist applicants in submitting required documentation through State's website, email, phone calls, and messaging portal
- Educate applicants on necessary documentation to qualify as necessary
- Adjudicated monetary and separation issues after conducting investigative fact-finding
- Cross-examined claimants and employer
- Used analysis and monitored reports to identify, validate, and document areas of individual and departmental trends
- Assists claimant in filing UI/PUA benefit claims, provides information on claim status Independently reviews, investigates, and determines if an individual is eligible or ineligible to receive UI/PUA benefits in accordance with UI/PUA laws, rules, regulations, and procedures
- Met team and client performance metrics, goals and deadlines
- Re-investigated questionable claims to identify signs of fraud and protect incorrect payouts.
DELIVERY SUPERVISOR/DISPATCH
TOPHAT LOGISTICS LLC
Livermore, CA
12.2017 - 04.2020
- Planning and managing logistics, warehouse, transportation and customer services
- Create policies or procedures for logistics activities
- Maintain metrics, reports, process documentation, customer service logs, or training or safety records
- Manage the day today delivery objectives to 100% compliances of goals set forth Following quality standards and procedures to minimize errors and maximize customer satisfaction
- Oversee the planned maintenance of vehicles
- Ensure Company follows laws and regulations regarding transportation, including hazardous materials
- Resolve any legal issues pertaining to transportation/distribution
- Reviewed orders before delivery and confirmed completeness and proper invoicing to optimize customer service
- Addressed customer complaints and proactively implemented resolutions to promote repeat business.
Call Center Customer Service Representative
Republic Services
Stockton, CA
10.2015 - 12.2017
- Effectively responds to routine issues regarding general residential and commercial service matters, which may involve outbound calls and other communication to resolve simple issues including, billings and service inquires
- Serves as primary customer advocate in solving escalated customer services issues by coordinating and ensuring issues resolution with local management team
- Completed assigned tasks with little or no supervision
- Participated in seminars and additional training to expand knowledge and skills
- Assisted team members and managers with tasks to maintain productivity and meet project milestones
- Reviewed activities regularly to identify opportunities for improvement.
Health Information Services Clerk
Sutter Gould Medical Foundation
Stockton, CA
12.2007 - 09.2015
- Organized and oversees record keeping activities related to the release of and retrieval of medical records for research projects
- Ensure that all medical records are released according to HIPPA guidelines
- Compile process and maintain records of hospital and clinic patient's in a manner consistent with medical, administrative, ethical, legal and regulatory requirements of the Health Care Systems
- Work closely with providers and Nurse Staff to assure smooth patient's flow and cut down waiting time
- Collect co payments Check in/outpatients to schedule a follow up visits.
CSR/MEDICAL UNDERWRITING ASSISTANT
CareFirst BlueCross BlueShield
Lodi, CA
08.2003 - 03.2007
- Responded to and resolved various customer inquiries by telephone
- Partnered with other department for online eligibility for billing
- Processed Health Plan applications with high level of accuracy
- Requested medical clarification, approved and forward applications to underwriting department using Blue Shield guidelines, and Federal and/or State legislation as appropriate
- Provided solutions, recommendations and replacements with empathy and positive feedback
- Assisted members with identifying and accessing care by locating in-network professionals
- Opened and closed accounts and processed applications
- Conducted follow-up calls at customer locations
- Authorized reinsurance of policy when risk is high
- Made the final determination to either approve or deny the request for insurance.
Service-focused Customer Service Representative
- Maximizing satisfaction and retention with proactive attention to individual customer needs
- Smoothly handles questions and resolves concerns with great problem-solving abilities and attention to detail
- Multitasks and manages time well to consistently meet performance targets.
Education
General educational development -
Oakland High School
Skills
- Underwriting
- Salesforce
- Cash Management Strategies
- Attention to Detail
- Microsoft Excel
- Critical Thinking
- Analytical Thinking
- Client Confidentiality
- Customer Expectations Management
- Regulatory Requirements Adherence
- Customer Referrals
- Client Engagement
- Risk Assessment
- Customer Complaint Resolution
Affiliations
- Make a Wish for the Elderly
- East Bay Asian Youth Center
- World Central Kitchen
Accomplishments
- EBAY-C Scholarship
- Plaza Robles High School Certification of Appericiation
- American Heart Association
Languages
Cambodian
Professional
Timeline
Large Group Specialty Department
Elevance Health
05.2023 - Current
Pua Adjudicator, Eligibility Benefits
AppleOne
02.2021 - 05.2023
DELIVERY SUPERVISOR/DISPATCH
TOPHAT LOGISTICS LLC
12.2017 - 04.2020
Call Center Customer Service Representative
Republic Services
10.2015 - 12.2017
Health Information Services Clerk
Sutter Gould Medical Foundation
12.2007 - 09.2015
CSR/MEDICAL UNDERWRITING ASSISTANT
CareFirst BlueCross BlueShield
08.2003 - 03.2007
Service-focused Customer Service Representative
General educational development -
Oakland High School
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