Alannah Samuel
Simpsonville,SC
Summary
Dynamic and results-oriented professional with extensive experience in customer service, claims processing, and account management. Recognized exceptional leadership, mentoring, and organizational abilities across fast-paced, high-volume environments. Proven ability to lead cross-functional teams, optimize workflows, and drive performance goals. I am seeking a leadership or managerial role where I can bring operational excellence, strong communication skills, and a team-first mindset.
Seasoned insurance professional with proven track record of effectively managing claims from initiation to resolution. Highly skilled in assessing coverage, coordinating with clients, and ensuring compliance with industry standards. Valued for strong team collaboration and adaptability in dynamic environments.
Experienced with evaluating claims for accuracy and compliance. Utilizes strong organizational skills and attention to detail to process claims efficiently. Track record of effectively communicating with clients and stakeholders to resolve claims disputes.
Professional with strong background in claims management, prepared to make significant impact. Skilled in assessing and processing claims accurately, resolving complex issues, and ensuring customer satisfaction. Effective team collaborator with focus on achieving results and adapting to changing needs. Known for analytical thinking, communication skills, and attention to detail.
Overview
16
16
years of professional experience
Work History
Patient Financial Advocate
Accredo Specialty Pharmacy
07.2018 - Current
- Reviewed and processed claims to ensure compliance with company policies and regulations.
- Collaborated with cross-functional teams to resolve complex claim issues efficiently.
- Educated clients on claims procedures, enhancing customer satisfaction and trust in services provided.
- Analyzed claim data to identify trends, recommending process improvements for efficiency.
- Mentored junior representatives, providing training on best practices and industry standards.
- Implemented quality control measures to improve accuracy of claim processing and reduce errors.
- Led initiatives to streamline workflows, resulting in faster turnaround times for claims resolution.
- Developed comprehensive reports on claims performance metrics for senior management review.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Followed up with customers on unresolved issues.
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
- Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
- Developed strong relationships with clients, facilitating trust and open communication during the claims process.
- Reduced claims processing times by approximately 30% through workflow optimization and improved case review procedures.
- Improved claims accuracy to over 95% by implementing double-check protocols and cross-functional audits.
- Managed a high-volume caseload of 80–100 claims daily while maintaining compliance with payer guidelines.
- Decreased denial rates by more than 20% through proactive reviews and corrective action strategies.
- Trained and mentored new staff members, improving onboarding efficiency and team productivity.
- Assisted in updating internal documentation and claims handling procedures to align with regulatory changes.
- Provided exceptional customer service, addressing concerns and resolving issues promptly.
- Developed in-depth understanding of insurance policies and procedures.
- Trained new Claims Representatives on company policies, procedures, and software systems, improving overall team productivity.
- Served as a subject matter expert on specialized claims, providing guidance and support to other team members when needed.
- Collaborated with internal departments and external vendors to resolve claims.
- Achieved high levels of accuracy in claim assessment, minimizing company's exposure to risk.
- Streamlined data entry processes, improving efficiency in claim file management.
- Streamlined billing processes for increased efficiency, implementing electronic claim submission methods.
- Assisted in staff training, sharing expertise on best practices in the patient billing process to improve overall team performance.
- Conducted thorough audits of patient accounts, identifying discrepancies and ensuring billing accuracy before finalizing statements.
- Supported organizational budgeting efforts by providing detailed revenue projections based on historical trends in the patient billing domain.
- Ensured timely payment collections by promptly following up on outstanding balances and negotiating payment plans.
- Supported revenue growth by accurately coding medical procedures for optimal reimbursement from insurance companies.
- Implemented new software systems to enhance the efficiency and effectiveness of the patient billing process within the organization.
- Collaborated closely with other departments, such as medical records and registration, to facilitate seamless coordination of the entire patient billing process.
- Managed accounts receivable tasks, regularly updating financial records to reflect current account statuses accurately.
- Assisted patients in understanding their insurance benefits, helping them make informed decisions about their healthcare expenses.
- Served as a reliable point-of-contact between patients, healthcare providers, and insurance companies to address any questions or concerns related to medical bills swiftly.
- Kept up-to-date with industry changes and regulations, attending training sessions and workshops to ensure ongoing expertise in patient billing processes.
- Enhanced patient billing accuracy by diligently reviewing and verifying insurance coverage information.
- Maintained strict compliance with HIPAA regulations when handling sensitive patient information during the billing process.
- Maintained a high level of customer satisfaction, addressing patient concerns and resolving billing disputes professionally.
- Expedited claim processing times by submitting clean claims free of errors that could cause delays or denials from insurance carriers.
- Reduced errors in patient billing through careful monitoring of data entry and adherence to company policies.
- Collaborated with healthcare providers to obtain necessary documentation for accurate bill submissions, reducing delays in payments.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted payments and collections on regular basis.
- Collected payments and applied to patient accounts.
- Verified insurance of patients to determine eligibility.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
Member advocate
Disabled Veteran Solutions
01.2016 - 06.2018
- Served as the primary point of contact for members, providing exceptional support, advocacy, and education on services, benefits, and resources available.
- Acted as a liaison between members and internal departments to resolve concerns, answer inquiries, and ensure member satisfaction across all touchpoints.
- Delivered tailored support to diverse populations by understanding unique needs, removing barriers to service, and promoting equitable access.
- Advocated on behalf of members to streamline processes, resolve issues related to claims, eligibility, or benefits, and ensure optimal service delivery.
- Collaborated with clinical teams, customer service, and case management to coordinate care and follow-ups, contributing to improved health outcomes and member retention.
- Maintained up-to-date and accurate documentation in CRM and case management systems in compliance with HIPAA and organizational standards.
- Identified patterns in member feedback and helped leadership implement service improvements and communication enhancements.
- Mentored new hires and promoted team development by sharing best practices and promoting a member-first mindset.
- Key Skills for This Role
- Member Engagement & Retention
- Conflict Resolution & De-escalation
- Benefits Explanation & Insurance Knowledge
- Cross-functional Communication
- CRM & Case Management Software
- Empathy & Cultural Sensitivity
- Documentation & HIPAA Compliance
- Team Collaboration & Leadership Support
Remarketing Specialist
Global Lending Services
07.2012 - 12.2015
- Managed end-to-end post-repossession vehicle remarketing operations, including inventory updates, auction coordination, and pricing strategy.
- Verified vehicle condition, assigned assets to appropriate sales channels, and ensured timely arrival and reconditioning prior to auction.
- Determined optimal resale venues and pricing using market tools such as NADA and MMR to maximize asset recovery value.
- Collaborated with internal departments to ensure compliance with legal notifications, documentation standards, and post-sale reporting.
- Maintained and updated inventory logs, damage estimates, and vehicle status with high accuracy and attention to detail.
- Acted as a liaison between auction houses and management, supporting execution of sales strategy and adjusting tactics based on market trends.
- Created deficiency letters, processed incoming mail, and communicated account updates with stakeholders.
- Contributed to process improvements and supported leadership in performance tracking and operational reporting.
- Key Skills for This Role
- Asset Recovery & Inventory Management
- Vehicle Valuation (NADA, MMR)
- Auction Coordination & Logistics
- Post-Repossession Compliance
- Analytical Thinking & Pricing Strategy
- Cross-Functional Collaboration
- CRM & Inventory Systems
- Documentation & Process Tracking
Account Manager
RTO National
03.2010 - 05.2012
- Oversaw account collections, customer outreach, and payment scheduling.
- Consistently meet or exceed collections goals while maintaining strong customer rapport.
- Trained new hires on customer service protocols and payment system operations.
- Played a key leadership role in building strong team culture and encouraging goal alignment.
Education
Diploma -
Hillcrest High School
Simpsonville06-2008
Bachelor of Science - Psychology
South College
Asheville, NC02-2027
Skills
- Leadership & Team Management
- Training & Development
- Claims & Account Oversight
- Microsoft office
- Insurance claims review
- Claims investigation
- Time management
- Team collaboration
- Data analysis
- Decision-making
- Interpersonal communication
- Coverage assessments
- Coverage determination
- Accident investigations
- Settlement negotiation
- Documentation review
- Workers compensation
- Database management
- File management
- Settlement determinations
- Conflict resolution
- Flexible schedule
- Claims trend analysis
- Insurance regulations
- Trade policy
- Documentation research
- Settlement agreements
- Accident review
- Allocating claims
- Claims processing
- Customer service
- Attention to detail
- Active listening
- Critical thinking
- Teamwork and collaboration
- Eligibility determination
- Claims adjustment
- Records management
- Documentation processing
- Insurance coverage verification
- Denied claims identification
- Financial transactions
- Information verification
- Payment and investigation escalations
- Organizing and prioritizing work
- Data integrity
- Document control
- Insurance claim forms review
- Patient contact
- Policy analysis
- Google suite proficiency
- Client interviews
- Small claims payouts
- Data entry software
- Prior authorization processing
- Collaborative relationships
- Data entry
- Financial counseling
- Healthcare industry
- Medical billing expertise
- Medical terminology
- Data entry proficiency
- Filing and data archiving
- Insurance verification
- Patient registration
- Caring and empathetic
- Organizational skills
- Effective communication
Timeline
Patient Financial Advocate
Accredo Specialty Pharmacy
07.2018 - Current
Member advocate
Disabled Veteran Solutions
01.2016 - 06.2018
Remarketing Specialist
Global Lending Services
07.2012 - 12.2015
Account Manager
RTO National
03.2010 - 05.2012
Diploma -
Hillcrest High School
Bachelor of Science - Psychology
South College