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yyyyyy x. yyyyyy

0000 xxxxxx xxxx , xxxx , xxxxx 00000 xxx-xxx-xxxx • abc@xyz.com

 

 

 

ba, forensic biology candidate with strong background in the medical/healthcare industry eager to contribute to the success of a progressive organization.

 

profile

 

  • offer solid and progressive professional experience, academic training and hands-on knowledge of healthcare support, claims processing and customer service capacities.
  • adept at blending strong decision-making abilities with outstanding organizational skills, solid leadership attributes, and successful interpersonal relationship-building techniques.
  • apply sharp problem-solving proficiencies, intelligent business acumen, and cost-effective strategies, along with exceptional written and verbal communication skills, to any professional environment.
  • capable of staying focused and maintaining a calm demeanor in high-pressure situations while exhibiting high quality, diplomatic customer / client services interaction both in person and via telephone.
  • demonstrate strong abilities in handling multiple projects simultaneously, meeting tight deadlines and working in a fast-paced professional environment.
  • dynamic communication, negotiation, presentation and relationship management skills.

 

professional experience

 

great west healthcare/cigna healthcare                                                                                    2000-2009

claims examiner ii

  • successfully handle a broad range of claims processing operations, from analyzing/researching claims for payment determination, eligibility verification and claim number assignment to the application of appropriate coding and claim pending/denial procedures.
  • effectively administer specified medical claims in accordance with contract provisions; utilize established policies and procedures in fulfilling claims to a designated payment authority level.
  • consistently ensure delivery of quality customer service vital to sustaining and growing clientele base through the timely processing of customer service referrals and claims adjustments within 48 hours of receipt.
  • cost-efficiently exceed daily production by 15%, promoted twice for exceeding 97.5% quality rate.
  • responsible for dissolving pend report through approved overtime.
  • serve as support to manager, assisting with all essential tasks in support of company target goals.

 

cigna healthcare                                                                                                                           1998-2000

indemnity/ppo tier ii processor

  • actively conferred with providers to generate information critical to accurate and timely claims processing.
  • effectively managed all medical claim processing functions, including updating information on policy/procedures and drafting monthly/weekly pending reports.

 

blue cross blue shield of georgia                                                                                                      1998

state department claims processor

  • successfully processed a broad range of medical claims on behalf of clientele while concurrently maintaining updates on state merit policies and guidelines.
  • utilized extensive training in medical claims processing and cpt coding in the administration of indemnity plan claims.

 

professional education

 

guilford college                                                                                        anticipated graduation may, 2009

bachelors degree of arts in forensic biology

member of tri beta biology honor society

 

georgia perimeter college                                                                                                                  2005

associate degree teacher education

member of phi theta kappa international honor society

yyyyyy x. yyyyyy

0000 xxxxxx xxxx , xxxx , xxxxx 00000 xxx-xxx-xxxx • abc@xyz.com

 

 

 

 

 

 

date

 

 

 

hiring agent name

title

company name

address

city/state/zip code

 

dear__________________:

 

i am currently seeking a challenging career opportunity in a (specific job title) capacity and am submitting my resume for your review.  in advance, thank you for your time and consideration.

 

as demonstrated in the accompanying resume, my professional qualifications include experience in managerial support, medical claims processing and customer service. an examination of my credentials will confirm that i am a skilled professional who thrives in a challenging work environment. i am driven, independently motivated, and results-oriented. i enjoy a challenge and work hard to achieve success. it is my practice to operate within a strict conduct of professionalism and integrity with my clientele. to complement this background, i offer dynamic communication, negotiation and diplomatic management skills.

 

as an employee, you will find me to be a driven team player committed to supporting you in achieving your objectives through superior performance.  i am confident that i could be a valuable asset to your firm, and look forward to interviewing with you in the near future.

 

sincerely,

 

 

 

 

 

yyyyyy x. yyyyyy


yyyyyy x. yyyyyy

0000 xxxxxx xxxx , xxxx , xxxxx 00000 xxx-xxx-xxxx • abc@xyz.com

 

 

 

 

 

 

date

 

 

 

contact name

company name

address

city/state/zip code

 

dear _______________________________:

 

i would like to thank you for providing me the opportunity to interview with you and discuss the exciting (specific job title) position currently available with your company.  having gained a deeper insight into the job requirements and your objectives, i am confident you will find me a valuable asset in achieving your goals.

 

as discussed, i am an enthusiastic, disciplined team player eager to launch a successful career as a dedicated member of your staff.  i believe you will find my dynamic customer service, managerial support and negotiation skills vital to your operations and look forward to contributing to your success.

 

should you have any additional questions, or to discuss future employment opportunities, please feel free to contact me at your earliest convenience.  again, thank you for the enlightening interview.  i look forward to your response.

 

sincerely,

 

 

 

 

 

yyyyyy x. yyyyyy

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