Terri Worthy
San Diego,CA
Summary
Customer Service professional with 25 years of experience assisting with and fulfilling organization accounting, billing, and membership needs. A proven track record of using my excellent personal, communication and organization skills to diagnose, analyze and solve a variety of quantitative and qualitative problems. Team player with excellent communication skills, high quality of work, driven, detail-oriented, and highly self-motivated. Strong analytical skills and business acumen and able to work independently Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Clerical Substitute
San Diego Unified School District
San Diego, California
10.2023 - Current
- Provided customer service assistance in person or via telephone when necessary.
- Assisted with data entry and filing of documents into appropriate records.
- Maintained a clean work area by organizing files and disposing of confidential documents properly.
- Ensured compliance with company policies regarding confidentiality of customer information.
- Answered and directed phone calls, emails, and other inquiries from staff and the public.
Planned Career Break
Family
San Diego
09.2021 - 10.2023
- Career break taken to provide full time caregiving to elderly family member.
Account Administration Representative
Kaiser Permanente
San Diego, CA
01.2009 - 09.2021
- Having worked as an Account Administration Representative, I was responsible for Identifying, researching, and reconciling billing payments amounts to ensure accurate eligibility determination, payment, revenue, and membership records
- I interacted with purchaser benefit administrators to answer questions and explain Health Plan policy and contractual provisions related to membership and billing
- Assisted Health Plan purchaser contacts and sales and service representatives in the sales process and the analysis and resolution of problems related to membership accounting, along with ensuring purchasers compliance with Health Plan policies and contractual provisions
- I facilitated interaction with all levels of Employer Benefits Administrators and staff to expediently respond to issues, problem solve and interpret Health Plan policy and procedures
- AAR experience in the following departments: Eligibility, Labor & Trust, Large Accounts, Contracts
- Instrumental in Accounts Receivable by keeping the book of business of $1.3 million a month through rigorous effort in billing, auditing, and follow-up of both current, delinquent, and aged accounts
- Performed key contractual duties by assisting with the production and distribution of contracts and related notices for new and renewing purchasers and individuals
- Ensured changes to contracts were quickly and accurately updated in the contract systems
- Participated in focus work groups and team-based projects contributing to customer service and operations improvements initiatives
- Participated in purchasers’ performance evaluations and performance target setting activities.
Workers Compensation Claims Assistant
Zenith Insurance
San Diego, CA
02.2005 - 02.2008
- Assisted workers compensation claims adjusters with management of files
- Kept adjusters abreast of issues regarding claims
- Investigated files by verifying claim and policy coverage
- Managed ongoing disability contacts, scheduled appointments and interpreters as needed
- Created medical only and indemnity folders
- Performed clerical duties such as sending benefit notices, closing letters, submitting medical cover letters, filing and sending claim acceptance kits, preparing settlement documents, and providing necessary information for AOE/COE
- Obtained, filed, and served documentation to assist litigated claims such as wage statements, job duty descriptions, DWC1, TD/PD history and independent rating of P&S reports
- Verified and calculated wage statements, scheduled temporary disability payments, paid mileage and interpreter bills, and arranged travel.
Education
Bachelor of Science Business Management -
University of The Redlands
Redland, CA12.2002
Skills
- Accounting/Finance/Accounts Receivable
- US Health Insurance Portability and Accountability Act (HIPPA)
- Medical and Current Procedural Terminology (CPT) Contracts
- Healthcare
- Microsoft Office 365
- Excellent time management skills
- Conflict Management
- Analytical and Critical Thinking
- Strong Ethics
- Assertive
- Loyal
- Business Acumen
- Workers' compensation knowledge
- Customer Service
Certification
Workers Compensation Claims Administrative Certificate (WCCA), 05/01/07
Community Service
- Terrace Green III Homeowners Association, President, 2020, Present
- Terrace Green III Homeowners Association, Board of Directors, 2018, Present
Timeline
Clerical Substitute
San Diego Unified School District
10.2023 - Current
Planned Career Break
Family
09.2021 - 10.2023
Account Administration Representative
Kaiser Permanente
01.2009 - 09.2021
Workers Compensation Claims Assistant
Zenith Insurance
02.2005 - 02.2008
Bachelor of Science Business Management -
University of The Redlands