Abby Mears
Bethany
Summary
Account Representative with 8+ years of healthcare and customer service experience, specializing in claims processing, third party billing, insurance verification, EMR/EHR systems, and HIPAA-compliant data entry. Manages high-volume claim workflows, resolves complex payer denials, and posts payments to support timely reimbursements while maintaining accuracy and confidentiality. Seeks to expand revenue-cycle responsibilities by applying analytical problem-solving, strong communication, and proficiency with medical coding and electronic records.
Overview
9
9
years of professional experience
Work History
Account Representative
Medsrv
04.2025 - Current
- Managed large volume of medical claims on daily basis.
- Resolved third-party payer issues such as denied medical claims.
- Resolved medical claims by approving or denying documentation, calculating benefits due, initiating payments and composing denial letters.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Resolved complex medical claims issues to support timely processing.
- Evaluated and resolved complex claims discrepancies, ensuring accuracy and compliance, which minimized rework and expedited payments.
- Coordinated with healthcare providers to gather necessary documentation, facilitating smoother claims submissions and reducing delays
Customer Service Representative
Faneuil
12.2022 - 03.2025
- Provided customer service as primary point of contact via inbound and outbound calls.
- Identified customer needs, provided resolutions to problems, and followed established procedures.
- Managed time effectively to meet call quotas, documented call activity, and safeguarded confidential information.
- Resolved customer inquiries efficiently through various communication channels.
- Maintained accurate records of customer interactions and transactions.
Enrollment Development Specialist
Faneuil
12.2020 - 11.2022
- Supported customers via inbound and outbound telephone calls, identified patient needs, provided information, scheduled appointments, and processed welfare checks.
- Documented call activity, complied with policies and procedures, and abided by HIPAA guidelines to ensure privacy.
- Demonstrated exceptional customer service skills while handling high-volume calls, enhancing client satisfaction and trust in the enrollment process.
- Implemented an efficient appointment scheduling system, reducing wait times and improving overall service delivery for clients.
- Led cross-functional teams to develop and implement strategic initiatives enhancing operational efficiency.
Customer Service Representative
Convergys
09.2019 - 07.2020
- Interact with customers via inbound and outbound calls to answer inquiries and to provide assistance and deliver little technical support.
- Document activity in customer accounts in an accurate manner and ensure confidentiality.
- Enter customer account data and communicate in a clear and concise manner. Identify customer needs, provide resolutions to problems, and follow established procedures.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
Customer Service Representative
Teleperformance USA
10.2017 - 08.2019
- Interact with customers via inbound and outbound calls to answer inquiries and to provide assistance and deliver little technical support.
- Document activity in customer accounts in an accurate manner and ensure confidentiality.
- Enter customer account data and communicate in a clear and concise manner. Identify customer needs, provide resolutions to problems, and follow established procedures.
- Analyzed feedback to improve overall customer satisfaction ratings.
- Implemented best practices to streamline workflow and reduce response times.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
Education
High School Diploma -
Waskom ISD
Waskom, TX05-2017
Skills
- Customer engagement
- CRM proficiency
- Customer relationship management
- Account management
- Prospecting skills
- Data tracking
- Web technologies and services
- Processing payments
- Teamwork and collaboration
- Problem-solving
- Time management
- Attention to detail
- Multitasking
- Excellent communication
- Customer satisfaction
- Organizational skills
- Reliability
Timeline
Account Representative
Medsrv
04.2025 - Current
Customer Service Representative
Faneuil
12.2022 - 03.2025
Enrollment Development Specialist
Faneuil
12.2020 - 11.2022
Customer Service Representative
Convergys
09.2019 - 07.2020
Customer Service Representative
Teleperformance USA
10.2017 - 08.2019
High School Diploma -
Waskom ISD