Dispute Resolution Specialist Resume Samples

Description :

1. Served as the main point of contact between patients, insurance companies, attorneys, and other professionals regarding care, coding and billing discrepancies, or any other problems or issues and proceed to report certain issues to the hospital.
2. Handled patient issues that have been escalated from the facilities, web inquiries, the C.F.O., or hospital administration.
3. Reviewed patient's complaints in entirety and how the account was charged, billed, and processed.
4. Requested audits by either contacting insurance companies or partner with appropriate department management for charge clarifications, risk management issues and P.F.S. to interpret what transpired on the account.
5. Followed-up with patients until issues are resolved, ensuring quality customer service for internal and external customers.
6. Created monthly reports regarding disputes, hospitals, resolutions, and timeframe for response.
7. Attended meetings to discuss effective strategies to become more efficient.

Experience

2-5 Years

Level

Junior

Education

BA in Business Administration

Description :

1. Transferred to rebates to determine correct dollars paid to vendors for goods sold.
2. Promoted to the dispute team which entailed researching the customer price that was being disputed and verified the correct price.
3. Processed credit and rebills as needed in a timely manner so invoices could be paid.
4. Developed a new team, CPA which was Customer Pricing Accuracy which I worked with the customers and their prices prior to the item being invoiced.
5. Transferred to the BBMC conversion team which we downloaded cost and price into the Cardinal system.
6. Compared prices and verify the customer price did not change during the conversion.
7. Stayed on that team until the conversion was complete.

Experience

10+ Years

Level

Senior

Education

BBM in Management

Description :

1. Assisted assigned businesses with solutions to consumer complaints in a timely manner.
2. Monitored business complaints about patterns, update the report when necessary.
3. Offered Light mediation and prepare reports, as needed.
4. Assure dbusinesses and consumers understand BBB dispute resolution procedures and policies.
5. Identified possible complaint patterns and create custom text to assure BBB reports accurately reflect marketplace activity.
6. Ran reports to maintain accuracy, ensuring all reviews are within our policy.
7. Established relationships with the public about any comments, concerns, or questions regarding our customer reviews.

Experience

5-7 Years

Level

Executive

Education

PhD in Organizational/Industrial Psychology

Description :

1. Responsible for ensuring that customer inquiries are resolved at the first point of contact unless specialist knowledge or further investigation is required.
2. Responded promptly to customer inquiries in person or via telephone, letter, and email - always in a professional & efficient manner.
3. Used the in-house system to record necessary information and instigate actions as required.
4. Processed orders, forms, applications, and requests for information.
5. Dealt efficiently with questions and queries from customers.
6. Kept up to date with all the company's products, services, and procedures.
7. Directed requests and unresolved issues to other colleagues.

Experience

0-2 Years

Level

Entry Level

Education

BS in Forensic Investigations

Description :

1. Responded to internal customer inquiries, resolving outside customer issues, and identifying sales opportunities that enhance customer relationships.
2. Take escalated calls and resolve internal and external customer issues.
3. Worked with customers to determine dispute rights/fraudulent activity on their bank accounts.
4. Resolved customer disputes in compliance with Visa and MasterCard regulations.
5. Assessed customer's loss factor for potential risk to the bank.
6. Processed disputes within proper timeframes to prevent bank losses.
7. Maintained up-to-date paper and computer-based files and administrative systems.

Experience

2-5 Years

Level

Junior

Education

Diploma

Description :

1. Membered of the specialized team responsible for goal setting, team decisions, and determining business needs of the dispute resolution unit.
2. Handled escalated (supervisor) calls and offered on-phone team member assistance.
3. Provided coaching and walkover assistance for dispute resolution team members.
4. Acted as liaison to other departments within the company.
5. Provided daily dispute case analysis.
6. Performed phone and file audits to ensure proper handling of customer inquiries.
7. Monitored and managed open work volumes daily.

Experience

2-5 Years

Level

Junior

Education

CPT In Billing And Anatomy

Description :

1. Analyzed and organized data submitted to Ford Motor Company by consumers.
2. Reviewed and assessed the validity of the content against designated standards in an effort to process buyback requests.
3. Prepared the documents needed to complete the lemon law review, request the vehicle's service records from the dealership.
4. Kept-case records up to date as the case is being processed.
5. Input the data from the service records into the prepared documents.
6. Uploaded the necessary documents to the case.
7. Drafted and submitted the Client's position and supporting documents.

Experience

5-7 Years

Level

Executive

Education

G.E.D

Description :

1. Displayed superior knowledge of products, services, terminology, procedures, and systems related to this area.
2. Processed provisional credits, sent required/requested documentation, and processed timely chargeback recoveries.
3. Provided exceptional customer service Managed compliance with Federal regulations and MasterCard/Visa operating regulations by applying rules to minimize losses to members and/or USAA when processing disputes.
4. Exercised excellent verbal and written communication skills.
5. Independently researched and resolved complex and/or difficult customer situations utilizing USAA's policies and procedures and recognized good judgment.
6. Part of the Mentoring team assigned to assisting, advising, and supporting peer training, shared duties, and system testing.
7. Collected documentation and prepare repair histories.

Experience

7-10 Years

Level

Management

Education

Fashion Retail Management

Description :

1. Maintained exemplary client service and impartiality while investigating lemon law claims against various automobile manufacturers.
2. Completed claim analysis to determine eligibility and discussed the remedies available with the client, local BBB office, and the manufacturer's representative.
3. Acted as an impartial liaison between all parties involved.
4. Recommended claims that could not be settled to be moved forward to the arbitration process.
5. Prepared all parties for arbitration and drafted settlement agreement letters.
6. Reviewed arbitrator decisions and followed up with consumers to ensure they were satisfied with the outcome of those proceedings.
7. Authored a training video as a visual aide for clients to obtain maximum results from the BBB Autoline Program.

Experience

5-7 Years

Level

Executive

Education

MS in Healthcare Administration

Description :

1. Processed customer fraud and dispute claim following department procedures while staying within established time frames and providing exceptional customer service.
2. Understood the Visa process for Chargebacks by ensuring that items presented for Chargeback meet the requirements of applicable Chargeback codes and are within the Regulation E timeframes.
3. Responded promptly and professionally to Customers regarding the resolution of issues.
4. Responsible for continuous improvement of job knowledge by exercising strong listening skills and asking questions for clarity.
5. Tracked, monitored, and reported issues relative to incomplete transmission procession.
6. Established and ensured compliance with departmental standards and processes to increase production and accommodate work volumes toward enhanced Customer satisfaction.
7. Processed letters from attorneys and customers regarding vehicle buybacks.

Experience

10+ Years

Level

Senior

Education

PhD in Organizational/Industrial Psychology