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Clamis Examiner Resume


Contact Candidate


Name:

Tommie

Location:

US-New York

Experience:

5-10 yrs

Most Recent Job Title:

Clamis Examiner

Objective:

To find a good work from home job that will replace my current full-time job. This will enable me to cut back on commuting cost such as gas and tolls. Not to mention the many other perks of working from home like being there for my daughter which to me is the most important.

Resume Text:

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nce Claims Approver/Enrollment Representative

Processing Affinity Health Plan Claims Based on Affinity Payment Policies and State Law.

Resolving Pended Status Claims Based on Affinity payment Policies and State Law.

Answering Phones and Resolving Inquiries/Problems Encountered by Members and/or Providers.

Reviewing and entering applications of prospective members of Affinity Healthplan as an Enrollment Rep.



ORTHONET, White Plains, NY 6/00-9/01

Insurance Claims Specialist

Processing Oxford Insurance Claims based on Oxford policies and State Law.

Entering MDNY Insurance Claims Information.

Processing MDNY Insurance Claims Based on MDNY policies and State Law.

Insurance Claims Auditing.



WORLD RESEARCH GROUP, New York, NY 2/00-6/00

Customer Service Representative

Registered customers for conferences for WRG by computer.

Resolving phone and computer inquiries.

Heavy clientele contact.

Filing, typing, faxing, answering phones.



CCN MANAGED CARE, White Plains, NY 8/99-2/00

Network Operations Assistant

Responsible for maintaining data integrity.

Initiated organization of files for efficiency in processing.

Screened and reviewed physician’s applications.

Managed technical function of provider information contained in CCN database (SAS).

Spoke to office managers and/or providers by phone in an effort to resolve outstanding issues.



Education:

JOHN JAY COLLEGE, New York, NY

Major: Legal Studies 9/88-5/92 (100 Credits Earned)



Skills: Proficient Knowledge. Amisys, Application Information Systems, MS Office/Excel, Word, SAS.

REFERENCES AVAILABLE UPON REQUEST


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