Alaneisha Nixon
Tomball,TX
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
17
17
years of professional experience
Work History
Customer Service Representative
UnitedHealthcare
02.2023 - Current
- Resolved customer complaints promptly and effectively, consistently delivering top-notch service.
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
- Updated databases with new and modified customer data.
- Adjusted bills and refunded money to resolve customers' service or billing complaints.
- Worked closely with other major insurance groups medicaid,medicare,commerical
Claims Processing Specialist Signature
Performance
01.2019 - Current
- Daily task of reviewing medicaid, and commercial insurance
- Checking over EOB to make sure the member had coverage for each line item at the time of visit
- Checking denial codes to determine elgibilty status
- required to meet 100 claims per day for production
- checking to make sure there are no duplicates payments on file
- Checked documentation for appropriate coding, catching errors and making revisions.
- Organized information by using spreadsheets, databases or word processing applications.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Retained strong medical terminology understanding in effort to better comprehend procedures.
- Prepared and reviewed insurance-claim forms and related documents for completeness.
- Coordinated and planned investigations of claims to confirm compensability and coverage.
Senior Processing Specialist
First Data
11.2014 - 06.2018
- Responsible for the sensitive processing of cases -Keep apprised of the latest processes, procedures, standards, and best practices -Research and evaluate various cardholder claims -Process chargebacks while resolving any customer complaints -Contact cardholders to investigate possible fraud -Build positive working relationships with team members
Inbound Sales Specialist
First Data
Omaha, NE
04.2013 - 11.2014
- Maintained strong relationships with customers from introduction to closing.
- Presented sales pitches to clients with basic needs.
- Stayed up to date on company offerings, product inventories and industry trends to increase revenue and maintain customer satisfaction.
- Applied good listening skills to determine customer preferences and financial limits.
- Engaged in conversation with customers to understand needs, resolve issues and answer product questions.
- Supported sales team members to drive growth and development.
- Collected deposits or payments and arranged for billing.
- Assisted customers with price checks, lifting heavy items and addressing other inquiries.
- Built trust and loyalty by maintaining professionalism while persuading customers.
- Improved overall customer purchasing experiences to promote steady revenue.
Client Service Specialist
First Data
Omaha, NE
01.2013 - 11.2013
- Directing calls and creating daily reports on Excel and Word
- Scanning, copying, faxing, and data entry
- Providing excellent customer service
- -Retaining Merchants to keep their business with our company
- -Updating and changing merchant bank account information
- -updating or changing merchants APR for processing their credits card with our company
- - Floor lead when supervisors were away or in meetings
- Responded within established timeframes to address customer concerns and inquiries by phone or email.
- Managed and updated physical and digital client account information to keep records accurate and current.
- Built sustainable client relationships built on trust by applying excellent communication and interpersonal skills.
- Meeting deadlines
Authorizations Specialist
First Data
06.2010 - 01.2011
- Processing credit card authorization for multiple banks
- Floor walker assisting coworkers with supervisor calls from irate customers
- Maintaining great quality scores
- Providing a great customer service in every call
- Participated in ongoing training and compliance activities.
- Balanced competing priorities through deliberate project and time management practices.
- Employed refined project management skills for task completion.
- Displayed strong telephone etiquette, effectively handling difficult calls.
Customer Service Representative
Telecheck
Omaha, NE
04.2008 - 04.2009
- Processing check for approvals
- Bringing on new business to start accepting telecheck
- Performed Technical support assisting the merchant with troubleshooting
- Floor walked and assisted coworkers with sup calls or help with solving a problem with an account
Fraud Investigator
First Data
Omaha, NE
09.2007 - 04.2008
- Sales, prospecting new accounts and building rapport
- Creating and managing account records
- Writing proposals and preparing presentations
- Cold calling and appointment setting
- Travel within a 65 mile radius of Omaha and Lincoln
- Input information regarding fraud investigations into detailed reports for submission to clients.
- Examined financial statements, written documents and audio files that could be used as evidence for fraud cases.
Education
Licensed Certified Radiology -
Kaplan University
01.2011
High School diploma -
Kaplan University, Northwest High School
01.2007
Skills
- Customer Service
- Organization skills
- Time Management
- Excellent communication skills
- Works well in groups
- Office Management Skills
- Documentation Skills
- Insurance Coverage Verification
- Payment and Investigation Escalations
- Skilled in word and excel
- Background in Insurance
- Account Management
- Organizing and Prioritizing Work
- Coverage Determination
- Paperwork Processing
- Active Listener
Timeline
Customer Service Representative
UnitedHealthcare
02.2023 - Current
Claims Processing Specialist Signature
Performance
01.2019 - Current
Senior Processing Specialist
First Data
11.2014 - 06.2018
Inbound Sales Specialist
First Data
04.2013 - 11.2014
Client Service Specialist
First Data
01.2013 - 11.2013
Authorizations Specialist
First Data
06.2010 - 01.2011
Customer Service Representative
Telecheck
04.2008 - 04.2009
Fraud Investigator
First Data
09.2007 - 04.2008
Licensed Certified Radiology -
Kaplan University
High School diploma -
Kaplan University, Northwest High School