Aleah Young
North Richland Hills,TX
Summary
Dynamic Provider Services Representative with a proven track record at United Health Care Group, excelling in customer service and claims processing. Enhanced operational efficiency and improved communication between providers and leadership, resulting in increased satisfaction. Skilled in data entry and process improvement, fostering collaboration across teams to resolve complex issues effectively.
Overview
5
5
years of professional experience
Work History
Provider Services Representative
United Health Care Group, Maryland Heights MO
10.2024 - Current
- Coordinated with internal departments on behalf of providers to ensure timely payment resolution for claims disputes or other financial matters.
- Enhanced customer satisfaction by efficiently resolving provider inquiries and concerns.
- Streamlined operations by managing a high volume of incoming calls for medical providers seeking information or assistance.
- Acted as a liaison between providers and company leadership, effectively communicating concerns and feedback to facilitate continuous improvement initiatives.
- Improved communication between providers and insurance companies, leading to better understanding of policy coverage and claim status.
- Educated providers on billing procedures, coding guidelines, and reimbursement policies for optimal claim submissions.
- Increased efficiency by accurately entering provider data into company systems and databases.
Advocate Member Service Representative
United Heathcare
09.2022 - 09.2023
- Exceeded monthly sales quotas by recommending additional services and products tailored to individual customer needs.
- Worked closely with management to implement process improvements that directly impacted overall team performance metrics.
- Contributed to the development of internal resources such as FAQs, product guides, and training materials.
- Educated customers on available products and services, promoting upselling opportunities when appropriate.
- Streamlined communication between clients and company departments for faster problem resolution.
- Enhanced customer satisfaction by efficiently resolving issues and addressing concerns.
Claims Processor
Humana
01.2020 - 01.2021
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Managed workload and priorities to meet claims processing meet deadlines.
- Collaborated with cross-functional teams to resolve complex claims issues efficiently and effectively.
- Trained new employees on claims processing procedures, contributing to a well-prepared workforce.
- Utilized specialized software to process incoming claims, enter data and generate reports.
- Followed up with customers on unresolved issues.
- Evaluated accuracy and quality of data entered into agency management system.
Education
Associate Of Business Administration - Business Administration
Hinds Community College
Raymond, MS05.2026
English
Wing-field High School
High School Diploma 05.2017
Skills
- Customer service
- Claims processing
- Data entry
- Process improvement
- Communication skills
- Team collaboration
Languages
English
Professional Working
Timeline
Provider Services Representative
United Health Care Group, Maryland Heights MO
10.2024 - Current
Advocate Member Service Representative
United Heathcare
09.2022 - 09.2023
Claims Processor
Humana
01.2020 - 01.2021
Associate Of Business Administration - Business Administration
Hinds Community College
English
Wing-field High School
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