To whom it may concern:
Having achieved many goals in my career in a variety of fields including insurance, management, and finance, I am interested in continuing my customer service management career. I am interested in obtaining a part time position as a Coder.
I currently hold a Bachelor of Arts degree from University of North Texas. I have two years of management experience which has assisted in developing my strong analytical skills, decision making abilities, communication abilities, ability to multi-tasking, customer focus, and team work. In addition, those two years of management experience has afforded me problem solving abilities, prioritization of daily workflow, organize, review and record data while multitasking and analytical skills. Also, I have twelve years of customer service experience. During this time I have obtained experience in building rapport with each customer, actively listen to their requests and inquiries; identify their needs and communicating with them effectively. I have thrived working in a team environment and exhibited a high level independence and initiative throughout my career. Further, in addition to my extensive office knowledge I have advance computer skills, strong work ethic, time management abilities, and I am very detailed oriented. I am highly trainable and very motivated.
My objective is to establish a time to discuss how my skill set will align with your company's current needs. Thank you for your consideration. I look forward to hearing from you to arrange an interview.
________________________________________________________________________
Tiffany K. Taylor
(424) 234-1589 ▪ tiffanyktaylor1@gmail.com
Education
CPC-A (AAPC) (pending exam in December) 2010
University of North Texas Bachelor of Science in Psychology 2003
GL Christian Academy High School Diploma 1996
Relevant Experience
I proactively sought out and am currently enrolled in a CPC course. I have learned the coding and abstracting of medical records in accordance with the current principles of ICD-9-CM, CPT coding guidelines, HCPCS and more knowledge of medical terminology.
Experience
Home Maker Beverly Hills, California
October 2009 – Current
My spouses' job relocated us from Houston, Texas to Los Angeles, California and it was a family decision that I resign from my previous position and become a home maker but now I am ready to get back into the work force.
Travelers Insurance Company Houston, Texas
First Party Medical Adjuster July 2008 – October 2009
• Handle low to moderately complex First Party Medical claims in fast paced and ever changing environment.
• Obtain, interpret, and evaluate UB04, CMS 1500 claim forms, ICD-9, CPT codes, medical records, benefit contracts and standard reference material.
• Match medical records and HIPPA authorization to claims and billing forms.
• Correspond daily with medical providers regarding patients' treatment and diagnosis.
• Manage medical payout and return-to-work strategies through Independent Medical Exams and Peer Reviews.
• Determines level of reimbursement based on established criteria, provider contract or calculations based on Medicaid/ Medicare reimbursement guidelines and company policies.
• Adjust claim monetary value based on patients' medical treatment being sought.
• Documents verbal and non-verbal information obtained from injured party, medical provider claims/billing forms to support payment, reimbursement and claim decisions.
• Adapt to varying workloads and work assignments on a constant basis.
• Successfully worked under highly stressful conditions.
• Process all claims eligible or ineligible for payment accurately and conforming to quality, production standards and specifications in a timely fashion.
• Researched database for accurate information for reimbursement rules involving specialty contracts.
• Multi-tasked using detail-oriented organizational skills to resolve claim assignments and the customer concerns.
• Communicated with customers from all backgrounds and upheld high standard of customer service.
• Settle the claims within authority by obtaining facts to evaluate coverage, negligence, medical necessity and causation/damages.
• Identify subrogation opportunities; handle adverse subrogation and arbitration.
• Recognize additional coverage issues as well as jurisdictional issues.
• Provide excellent customer service on a daily basis.
CitiGroup Dallas, Texas September 1999 - July 2008
Team Lead/ Operations Assistant (CITIGROUP) March 2006 – July 2008
• Support 22 direct reports on a daily basis coaching, maintaining workflow, monitoring processing statistics and report for the
employees in three different departments and monthly reporting for departmental activities. Conduct account quality reviews for
team.
• Made independent judgments based on current policies, procedures ethical principles.
• Collaborated with multidisciplinary team members in office and overseas.
• Adapted to varying workloads and assignments on a constant basis.
• Review in detail insurance property damage appraisals and invoices from auto body shop to determine repairs to automobile were completed per the insurance appraisal to ensure restore vehicle to pre-loss condition.
• Review in detail insurance total loss evaluations to ensure settlement is comparable to NADA value.
• Process escalated customer requests on a daily basis.
• Propose ideas and make recommendations regarding improvements in Department Operations and Business Practices. Update policies and procedures for the Department.
• At end of business day ensure production floor is within Compliance guidelines before leaving for the day.
• Resolve escalated Departmental issues and Exception processing while evaluating company financial and legal risk.
• Solely responsible for maintaining workflow for 45 employees at 100 accounts per employee.
Executive Response Unit Research Specialist (Dual position - CITIGROUP) March 2006
• Using software conducted data searches, using Excel organized this data and communicated finding to Senior Management.
• Conduct in-depth investigation into loan accounts in response to customer's disputes received via phone call, fax, email or mail which includes corresponding with all entities of CitiFinancial Auto, drafting letters pertaining to balance disputes, loan account validation, payment inquires, credit bureau reporting, and Insurance Support Department related issues.
• Researched loan accounts for and gather documents requested in Custodian of Records for Subpoena.
• Communicated orally and written with Senior Management to communicate customer needs and to act as the customer advocate to retain the customer's relationship.
Claims Examiner (CITIGROUP) December 2004-March 2006
• Assist customers, insurance companies and auto repair shops with damage and total loss claims.
• Responsible for assisting disgruntled customers.
• Responsible for acting as primary contact person for Balboa Insurance Company.
• Manage the Departmental Communications.
• Solely responsible for preparing documents for Physical Damage to be forwarded to the Imaging Department.
Customer Service Representative (CITIGROUP) September 1999 – December 2004
• Assist customers with inquires and disputes on their credit card accounts.
• Investigate accounts and probe customer by questioning to determine and direct customers to other Departments as needed.
• Post payments to customer's accounts.
• Assists customers with explaining the advantages of their card accounts.
Aegis Communications Group Dallas, Texas
Customer Service Representative June 1997 - August 1999
• Coach coworkers and maintain positive work environment.
• Assisted American Express customers by enrolling them into the phone pay system.
• Served as a member of Technology Helpdesk by re-setting coworkers system ID's and passwords.
• By willingness to assist coworkers and becoming a subject matter expert was promoted to Problem Solving Phone lines.
• Assist Managers with projects as assigned.
Skills
▪ Windows XP ▪ Outlook ▪ Word ▪ Excel ▪ AutoPro ▪ CACS (Solana Mainframe) ▪ CSW ▪ Ascent Capture 7.0 ▪ Right Fax ▪ Avaya CMS ▪ Envision Telephony ▪ IBM Content Manager for ISeries ▪ Adobe Acrobat Reader 7.0 Standard ▪ ShowCase Suite 7.0 ▪ Remedy ▪ ClaimNet ▪ IMPACT ▪ MedBill Pro ▪ Mitchell Medical ▪ 65 WPM ▪ 8500 key strokes ▪
Having achieved many goals in my career in a variety of fields including insurance, management, and finance, I am interested in continuing my customer service management career. I am interested in obtaining a part time position as a Coder.
I currently hold a Bachelor of Arts degree from University of North Texas. I have two years of management experience which has assisted in developing my strong analytical skills, decision making abilities, communication abilities, ability to multi-tasking, customer focus, and team work. In addition, those two years of management experience has afforded me problem solving abilities, prioritization of daily workflow, organize, review and record data while multitasking and analytical skills. Also, I have twelve years of customer service experience. During this time I have obtained experience in building rapport with each customer, actively listen to their requests and inquiries; identify their needs and communicating with them effectively. I have thrived working in a team environment and exhibited a high level independence and initiative throughout my career. Further, in addition to my extensive office knowledge I have advance computer skills, strong work ethic, time management abilities, and I am very detailed oriented. I am highly trainable and very motivated.
My objective is to establish a time to discuss how my skill set will align with your company's current needs. Thank you for your consideration. I look forward to hearing from you to arrange an interview.
________________________________________________________________________
Tiffany K. Taylor
(424) 234-1589 ▪ tiffanyktaylor1@gmail.com
Education
CPC-A (AAPC) (pending exam in December) 2010
University of North Texas Bachelor of Science in Psychology 2003
GL Christian Academy High School Diploma 1996
Relevant Experience
I proactively sought out and am currently enrolled in a CPC course. I have learned the coding and abstracting of medical records in accordance with the current principles of ICD-9-CM, CPT coding guidelines, HCPCS and more knowledge of medical terminology.
Experience
Home Maker Beverly Hills, California
October 2009 – Current
My spouses' job relocated us from Houston, Texas to Los Angeles, California and it was a family decision that I resign from my previous position and become a home maker but now I am ready to get back into the work force.
Travelers Insurance Company Houston, Texas
First Party Medical Adjuster July 2008 – October 2009
• Handle low to moderately complex First Party Medical claims in fast paced and ever changing environment.
• Obtain, interpret, and evaluate UB04, CMS 1500 claim forms, ICD-9, CPT codes, medical records, benefit contracts and standard reference material.
• Match medical records and HIPPA authorization to claims and billing forms.
• Correspond daily with medical providers regarding patients' treatment and diagnosis.
• Manage medical payout and return-to-work strategies through Independent Medical Exams and Peer Reviews.
• Determines level of reimbursement based on established criteria, provider contract or calculations based on Medicaid/ Medicare reimbursement guidelines and company policies.
• Adjust claim monetary value based on patients' medical treatment being sought.
• Documents verbal and non-verbal information obtained from injured party, medical provider claims/billing forms to support payment, reimbursement and claim decisions.
• Adapt to varying workloads and work assignments on a constant basis.
• Successfully worked under highly stressful conditions.
• Process all claims eligible or ineligible for payment accurately and conforming to quality, production standards and specifications in a timely fashion.
• Researched database for accurate information for reimbursement rules involving specialty contracts.
• Multi-tasked using detail-oriented organizational skills to resolve claim assignments and the customer concerns.
• Communicated with customers from all backgrounds and upheld high standard of customer service.
• Settle the claims within authority by obtaining facts to evaluate coverage, negligence, medical necessity and causation/damages.
• Identify subrogation opportunities; handle adverse subrogation and arbitration.
• Recognize additional coverage issues as well as jurisdictional issues.
• Provide excellent customer service on a daily basis.
CitiGroup Dallas, Texas September 1999 - July 2008
Team Lead/ Operations Assistant (CITIGROUP) March 2006 – July 2008
• Support 22 direct reports on a daily basis coaching, maintaining workflow, monitoring processing statistics and report for the
employees in three different departments and monthly reporting for departmental activities. Conduct account quality reviews for
team.
• Made independent judgments based on current policies, procedures ethical principles.
• Collaborated with multidisciplinary team members in office and overseas.
• Adapted to varying workloads and assignments on a constant basis.
• Review in detail insurance property damage appraisals and invoices from auto body shop to determine repairs to automobile were completed per the insurance appraisal to ensure restore vehicle to pre-loss condition.
• Review in detail insurance total loss evaluations to ensure settlement is comparable to NADA value.
• Process escalated customer requests on a daily basis.
• Propose ideas and make recommendations regarding improvements in Department Operations and Business Practices. Update policies and procedures for the Department.
• At end of business day ensure production floor is within Compliance guidelines before leaving for the day.
• Resolve escalated Departmental issues and Exception processing while evaluating company financial and legal risk.
• Solely responsible for maintaining workflow for 45 employees at 100 accounts per employee.
Executive Response Unit Research Specialist (Dual position - CITIGROUP) March 2006
• Using software conducted data searches, using Excel organized this data and communicated finding to Senior Management.
• Conduct in-depth investigation into loan accounts in response to customer's disputes received via phone call, fax, email or mail which includes corresponding with all entities of CitiFinancial Auto, drafting letters pertaining to balance disputes, loan account validation, payment inquires, credit bureau reporting, and Insurance Support Department related issues.
• Researched loan accounts for and gather documents requested in Custodian of Records for Subpoena.
• Communicated orally and written with Senior Management to communicate customer needs and to act as the customer advocate to retain the customer's relationship.
Claims Examiner (CITIGROUP) December 2004-March 2006
• Assist customers, insurance companies and auto repair shops with damage and total loss claims.
• Responsible for assisting disgruntled customers.
• Responsible for acting as primary contact person for Balboa Insurance Company.
• Manage the Departmental Communications.
• Solely responsible for preparing documents for Physical Damage to be forwarded to the Imaging Department.
Customer Service Representative (CITIGROUP) September 1999 – December 2004
• Assist customers with inquires and disputes on their credit card accounts.
• Investigate accounts and probe customer by questioning to determine and direct customers to other Departments as needed.
• Post payments to customer's accounts.
• Assists customers with explaining the advantages of their card accounts.
Aegis Communications Group Dallas, Texas
Customer Service Representative June 1997 - August 1999
• Coach coworkers and maintain positive work environment.
• Assisted American Express customers by enrolling them into the phone pay system.
• Served as a member of Technology Helpdesk by re-setting coworkers system ID's and passwords.
• By willingness to assist coworkers and becoming a subject matter expert was promoted to Problem Solving Phone lines.
• Assist Managers with projects as assigned.
Skills
▪ Windows XP ▪ Outlook ▪ Word ▪ Excel ▪ AutoPro ▪ CACS (Solana Mainframe) ▪ CSW ▪ Ascent Capture 7.0 ▪ Right Fax ▪ Avaya CMS ▪ Envision Telephony ▪ IBM Content Manager for ISeries ▪ Adobe Acrobat Reader 7.0 Standard ▪ ShowCase Suite 7.0 ▪ Remedy ▪ ClaimNet ▪ IMPACT ▪ MedBill Pro ▪ Mitchell Medical ▪ 65 WPM ▪ 8500 key strokes ▪