MS Office
Sylvia Thompson
Client Services Representative
Penticton,BC
Summary
High-energy Client Services Representative in Mental Health with demonstrated administrative expertise, analytical problem-solving skills and proficiency in many software applications. Proven history of delivering exceptional client service through proactive communication and diligent follow-up. Highly organized, responsive and versed in managing client expectations to foster loyalty.
Overview
34
34
years of professional experience
2
2
years of post-secondary education
3
3
Certifications
2
2
Languages
Work History
Client Services Representative
WorkSafeBC
Kelowna, BC
08.2006 - 06.2022
- First point of contact for injured workers, employers, medical community and advocates.
- Answer claims related phone enquiries
- Address client's questions and concerns
- Reviewed all new claims to the work location
- Collected and reviewed missing or conflicting information and documented for the claim file
- Assumed responsibility for the entitlement decision regarding no wage loss claims, routine short term disability claims and first payments
- Performed a variety of duties related to the management of the caseload and other duties as assigned
Medical Office Assistant
Dr. Katherine R Gross
Penticton, BC
08.1997 - 09.2004
- Coordinated patient scheduling, check-in, check-out and payments for billing.
- Adhered to strict HIPAA guidelines to protect patient privacy.
- Entered procedure codes and diagnosis codes into medical billing software.
- Gathered forms and copied insurance cards to collect patient information for billing and insurance filing.
- Coordinated referrals through insurance and other medical specialists and documented details in patient charts.
- Greeted visitors and initiated triage processes for clients to streamline patient flow.
- Organized and maintained patient chart filing system to promote quick data finding for staff.
- Managed office logistics by scheduling appointments, maintaining files and collecting payments.
- Restocked each medical room with adequate supply of medications and supplies in preparation for patients.
- Called and faxed pharmacies to submit prescriptions and refills.
- Directed patients to exam rooms, fielded questions and prepared for physician examinations.
- Received and routed laboratory results to correct clinical staff members.
- Placed new supply orders, managed inventory and restocked clerical spaces.
- Implemented software for digitizing and organizing over medical records.
Claims Adjudicator
WorkSafeBC
Vernon And Penticton , BC
01.1977 - 10.1987
- Prepared and presented claims to other insurance companies and collaborated to gain necessary information to resolve claims.
- Executed claims processing
- Investigated high volume of claims to determine validity and coverage eligibility.
- Collaborated with team members and management to meet goals.
- Determined claim status and negotiated to reach reasonable settlements or denials.
- Communicated with clients to explain policy coverage and regulations.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Reviewed and analyzed suspicious and potentially fraudulent claims.
- Interviewed claimants and witnesses to gather factual information.
- Collaborated with claims department and industry anti-fraud organizations to resolve claims.
- Examined photographs and statements.
- Researched claims and incident information to deliver solutions and resolve problems.
- Consulted police and hospital records when needed.
- Corrected codes to properly classify claims.
Education
High School Diploma -
Steveston Senior Secondary
Richmond BC 09.1970 - 06.1972
Skills
Complaint resolution
Multi-line phone talent
Medical terminology knowledge
Stocking and replenishing
Shipping procedures understanding
Professional telephone demeanor
Service standard compliance
Report preparation
Receiving support
Accomplishments
- Telephone Service - Professionally many calls per day, providing information and service to ensure customer satisfaction.
- Customer Follow-up - Ensured that workers were satisfied with decisions
- Conflict Resolution - Responsible for handling customer claims inquiries, accurately providing information to ensure resolution the claims process
- Collaborated with team members in the development of projects to improve workflow
- Documented and resolved issues which led toclaims decisions.
Software
WorkSafeBC specific
Osler
Certification
Mental Health First Aid Certificate
Interests
Running
Hiking
Stand Up Paddle Boarding
Cycling
Hobbies
I am actively involved in the Interior Running Association as a Member at Large.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Mental Health First Aid Certificate
01-2019
Client Services Representative
WorkSafeBC
08.2006 - 06.2022
Medical Office Assistant
Dr. Katherine R Gross
08.1997 - 09.2004
Defusing Customer Hospitality
02-1987
Problem Solving & Decision Making
11-1979
Claims Adjudicator
WorkSafeBC
01.1977 - 10.1987
High School Diploma -
Steveston Senior Secondary
09.1970 - 06.1972