Aaliyah Neeley
Carrollton,GA
Summary
A detail-oriented and efficient Claims Processor with 5 years of experience in the insurance industry, skilled in accurately reviewing and processing high volumes of claims while ensuring compliance with policy guidelines, demonstrating strong analytical abilities to identify claim validity and effectively resolve customer inquiries.
Overview
5
5
years of professional experience
Work History
Plan advisor and Claims Representative
United Health Group
Carrollton, USA
06.2022 - 12.2024
- Promoted within one year for determining optimal direction for company on a strategic level
- Assisted with inbound calls for members of UMR Medical Benefits plans
- Efficiently Skilled in UMR CPS and Jacada programs
- Transferred misdirected callers to appropriate departments internally
- Update members’ call tracks with important information discussed during phone call
- Maintained Provider calls during peak season regarding claim status and Prior Authorizations
- Processed various UMR medical claims with denials, duplicates, and corrections of errors with 61 pends
Customer Service and Claims Representative
United Health Group
Carrollton, USA
06.2022 - 12.2024
- Assisted with inbound calls for members of UMR Medical Benefits plans
- Explain and answer any questions regarding coinsurance and deductible amounts to UMR members
- Efficiently Skilled in UMR CPS and Jacada programs
- Transferred misdirected callers to appropriate departments internally
- Update members’ call tracks with important information discussed during phone call
- Maintained Provider calls during peak season regarding claim status and Prior Authorizations
- Processed various UMR medical claims with denials, duplicates, and corrections of errors with 61 pends
Front Office Call Center Coordinator
Professional Park Medical Services
Carrollton, USA
07.2019 - 03.2021
- Adeptly managed multi-line phone system and pleasantly greeted and checked in all patients
- Managed master calendar and scheduled appointments for 3 MD's and 3 NP's based on optimal patient loads and clinician availability in call center
- Collected payment of deductible collections and co-pays/co-insurance for patients on each appointment
- Completed insurance verification and/or prior authorization, as well as checked out each patient
Education
Dental Hygienist -
Dental Staff
Douglasville, GA11-2019
Skills
- Interpersonal communication skills
- Appointment scheduling
- CPT/ICD-10, and Dental Coding
- UMR, CPS, Jacada, and JIA
- VCC Desktop and OnBase
- Insurance Verification and Billing
- Medical Claims Processor
- Microsoft PC Applications
Accomplishments
- Met quarterly quality metrics 2022-2025
Timeline
Plan advisor and Claims Representative
United Health Group
06.2022 - 12.2024
Customer Service and Claims Representative
United Health Group
06.2022 - 12.2024
Front Office Call Center Coordinator
Professional Park Medical Services
07.2019 - 03.2021
Dental Hygienist -
Dental Staff
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