Sophia Thompson
Jackson,Mississippi
Summary
- Dedicated Customer Service professional with history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
- To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
2
2
years of professional experience
Work History
Patient Resolution Specialist
HBCS
New Castle, DE
06.2022 - Current
- Explain/collect co-pays,deductibles,and other patient balances when needed.
- Make patients fully aware of financial obligations and eligibility for programs that may provide financial assistance.
- Explain EOB for denial of claims, order UB04 for patients when requested.
- Performed targeted collections on past due accounts aged over 30 days.
- Worked effectively with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely and accurate payments.
Customer Service Representative(WFH)
NTT Data
NA, OK
01.2022 - 02.2022
- Handle simplex to more complex in-bound calls from clients and answer questions regarding life or annuity products and/ or servicing needs.
- Process some routine and more complex transactions and documents records with consistent quality and attention to detail.
- Interprets each request and navigate multiple systems as well as our workflow and imaging tool to gain and document needed information.
- Own customer experience by establishing trust and building relationships with financial professionals and customers to provide high caliber service and follow-through.
Customer Service Representative (WFH)
We-Insure
NA, Florida
11.2021 - 01.2022
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Answered constant flow of customer calls with minimal wait times.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Recommended products to customers, thoroughly explaining details.
Claims Processing Specialist (WFH)
Req-Route
Na, CA
08.2021 - 10.2021
- Process insurance claims in accordance with policies, procedures, and guidelines..
- .Resolve problems of incorrect denials, payments, adjustments.
- Demonstrate knowledge of possessing the ability to access all relevant computer systems and screens to process claim accurately. .
- Approving, pending or denying claims.
- Identifying and referring all claims with potential third-party liability (subrogation, COB.MVA, stop loss claims and potential stop loss files.
- Facets claims knowledge.
Customer Service Representative (WFH)
Sedgwick
NA, WFH
11.2020 - 07.2021
- Provide decisions to members once a claim is complete. Would inform the member if claim is approved or denied; and explain the appeal process.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Educate members about the process of their FLMA claim in reference to time frames, payment information, and benefit information.
- Documented and detailed calls and complaints using call center's CRM database.
- Follow client specifications while assisting members with the start of new claims for members.
Workers' Compensation Claims Representative (WFH)
Rev Claims
Jackson, MS
03.2020 - 11.2020
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Examined claims forms and other records to determine insurance coverage.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Contacted patients,employers and insurance companies to verify patient demographics, and benefits.
- Contacted hospitals to obtain additional information required to process the claim.
Education
No Degree - Medical Billing And Coding
Holmes Community College
Goodman, MSHigh School Diploma -
Lanier High School
Mississippi05.1999
Skills
- Documentation Review
- HIPAA trained and compliant
- Medical claims and other systems experts: Claim capture, Facets, Epic
- Data Entry
- Attention to Detail
- Dependable and Responsible
Timeline
Patient Resolution Specialist
HBCS
06.2022 - Current
Customer Service Representative(WFH)
NTT Data
01.2022 - 02.2022
Customer Service Representative (WFH)
We-Insure
11.2021 - 01.2022
Claims Processing Specialist (WFH)
Req-Route
08.2021 - 10.2021
Customer Service Representative (WFH)
Sedgwick
11.2020 - 07.2021
Workers' Compensation Claims Representative (WFH)
Rev Claims
03.2020 - 11.2020
No Degree - Medical Billing And Coding
Holmes Community College
High School Diploma -
Lanier High School