Cedric Mills Email & Phone Number

Greensboro/Winston-Salem, North Carolina Area

• Analyzed and approved routine claims that cannot be auto adjudicated -Apply guidelines, resolve eligibility issues, and identify and resolve discrepancies to complete the claim adjudication process, processing patient claims.• Verified eligibility verification/followed medical necessity guidelines and ensured cost measures for claim adjudication/adjustment.• Audited claims to ensure that the appropriate coding, procedure, member information and diagnosis are correct for processing and payment.• Utilized all applicable system functions available ensuring accurate and timely claim processing service (i.e., utilizes Claim Check, reasonable and customary data, and other post-containment tools).

Greensboro/Winston-Salem, North Carolina Area

Non-profit Support Group for the unemployed and the unemployed that has touched the lives of over 10,000 people sine 1992. • Researched networking and job opportunities through internet-based options.• Volunteered at job fairs to present information about support group to attendees.

Greensboro/Winston-Salem, North Carolina Area

• Ensured the security, safety and well-being of all personnel, visitors and the premises.• Secured premises and personnel by patrolling property; monitoring surveillance equipment; inspecting buildings, equipment and control access points; permitting entry.• Monitored video controls for safety and followed policies and procedures.• Responsible for the security of over $10,000,000 in vehicles• Answered phone calls concerning vendors, handled complaints, and responded to requests for information.

Winston-Salem, Nc

• Processed over 24,000 medical insurance and Medicare claims per year in an accurate and timely manner.• Analyzed 12,000 medical insurance claims per year for correct payment and adjustments.• Verified that the claim data was accurate and compliant to applicable regulations.• Tested new programs and integrity of applications to ensure that they ran accurately and efficiently.• Communicated with other departments to complete escalations within a timely manner• Monitored claims for errors and escalated the issue to processors.• Examined and responded to update provider correspondence based on claim guidelines and processes.• Responded to claims processing inquiries from Customer Service Professionals, subscribers and providers/vendors.• Cross trained and helped two other departments due to higher volume.• Demonstrated ability to pick up new operational policies and procedures quickly and efficiently.• Adapted analytical skills to research projects using Excel spreadsheets and Microsoft Word.• Involved with system upgrades and enhancements by acting as the liaison with the IT project team.• Collaborated with team leads, business analysts, and claims operations to process and streamline claims to reduce costly errors.• Received Employee of the Month in recognition of excellent job performance and dedication to customer service.

Greensboro,Nc

• Identified and researched documentation and transactions for over 60,000 domestic, international consumer and business loan accounts.• Performed high volume, time sensitive tasks related to the loan documentation processwhich includes researching and problem solving to ensure compliance with customer loyalty, quality, and timeliness standards.• Maintained and verified collateral for over 40,000 customer and closed loan accounts.• Analyzed over 800 loan modification/property insurance documentation to prequalify applicants. • Verified 15,000 loan documents and sent accurate collateral to the customers.• Sorted, organized, and maintained electronic and manual records accurately, updating existing records and adding new records onto database systems.• Inspected and maintained all areas of responsibility to ensure compliance with company goals and policies

Associate'S Degree, Computer And Information Sciences And Support Services

Associate'S Degree, Business Administration And Management