Aleysha Mills
Chesapeake,VA
Summary
Detail-oriented professional with a strong team orientation, dedicated to creating value for customers by surpassing high-quality metrics. Possesses exceptional analytical skills, precise and rapid keyboarding abilities, and advanced proficiency in computer navigation within a Windows environment. Effective verbal and written communication skills, coupled with a positive and adaptable attitude, characterize my approach to work. Prior experience in medical claim processing enhances my qualifications. Comfortable with quality and production goals, I am committed to meeting service expectations while being monitored for accuracy, efficiency, and customer satisfaction. Eager to contribute to a dynamic team environment and open to adapting quickly to change. Comprehensive training background ensures a solid foundation for achieving objectives.
Overview
7
7
years of professional experience
Work History
Security Officer
Allied Universal Security Services
04.2024 - Current
- Greeted guests professionally and courteously to cultivate welcoming atmosphere while making safety top priority.
- Conducted regular patrols of key areas to spot and control security concerns.
- Gathered information, identified, and implemented resolution, planned follow-up and logged and filed incident report to successfully manage complaints.
- Trained new Security Officers in company policies, ensuring consistent knowledge across the team and adherence to established procedures.
- Managed access control systems efficiently, ensuring accurate records of employee badges for restricted areas were maintained at all times.
- Enhanced security measures by staying up-to-date on industry best practices, attending training sessions, and obtaining relevant certifications.
- Placed necessary outgoing calls to verify alarms, dispatch proper authorities and notify proper parties.
- Monitored CCTV cameras and alarm systems for security breaches.
- Updated shift logs and produced daily reports to document security activities and specific incidents.
- Issued access cards to authorized personnel to monitor access points.
Warehouse Worker
Target Distribution Center (FT)
09.2020 - 01.2023
- Received and tracked incoming inventory shipments.
- Organized warehouse space for efficient storage of products.
- Maintained a clean work area by sweeping, mopping, dusting shelves.
- Processed returns of defective merchandise as required.
- Followed established guidelines for picking orders accurately.
- Transported goods to designated areas within the warehouse facility.
- Prepared and completed warehouse orders for delivery or pickup according to schedule.
- Used pallet jacks to move items to and from warehouse locations.
- Kept shelves, workstations and pallet areas neat and tidy to maintain safe work environment.
- Operated scanners, computers, and other equipment to track orders.
Member Service Representative
Conduent (Moved to a Different Department)
08.2021 - 01.2022
- Leverages years of specialized experience in group health insurance administration, focusing predominantly on carrier enrollment, to ensure streamlined operations and accurate client records.
- Conducts meticulous reconciliation of monthly carrier invoices against client records for a year, ensuring 100% accuracy and resolving discrepancies promptly, which resulted in enhanced financial integrity.
- Demonstrates excellent customer service skills over years, addressing and resolving client queries and concerns promptly and effectively, achieving a 95% customer satisfaction rate.
- Applies in-depth knowledge of COBRA, HIPAA, EDI files, Qualifying Life Events (QLE), and Protected Health Information (PHI) to manage and resolve complex eligibility issues, reducing resolution time by 25%.
Medical Claims Specialist
Conduent (PT)
04.2020 - 08.2021
- Provided expertise or general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims.
- Analyzed and identified trends and provide reports as necessary.
- Consistently met established productivity, schedule adherence and quality standards.
- Reviewed and analyzed insurance claims to determine validity, completeness, accuracy, and eligibility for payment.
Enrollment Eligibility Representative
Alorica (FT)
07.2019 - 04.2020
- Performed medical/pharmacy benefit verification by contacting insurance companies or using provider portals for drug coverage and benefits.
- Facilitated cross-functional resolution of drug coverage issues and will proactively address, research & resolve issues resulting in timely onboarding of specialty patients.
- Coordinated and ensures services provided will be reimbursable (e.g., deductible amounts, co-payments, effective date, levels of care, authorization, etc.).
- Performed insurance review on day of shipment to ensure insurance criteria is met for reimbursement and reduce the risk of bad debt.
Cashier
Food Lion (PT)
07.2017 - 07.2019
- Greeted customers entering store and responded promptly to customer needs.
- Welcomed customers and helped determine their needs.
- Worked flexible schedule and extra shifts to meet business needs.
- Operated cash register for cash, check, and credit card transactions with excellent accuracy levels.
- Helped customers complete purchases, locate items, and join reward programs.
- Assisted customers with returns, refunds and resolving transaction issues.
- Assist customers by providing information and resolving their complaints.
- Count money in drawers at the beginning and end of shifts to ensure that amounts are correct and that their is adequate change.
- Cash checks for customers.
Education
Pharmacy Tech -
Tidewater Community College
Portsmouth, VAHigh School Diploma -
Western Branch High School
Chesapeake, VA06.2018
Skills
- Claims Processing
- Call Center Operations
- Data Entry
- Conflict Resolution
- Strong Time Management
References are available upon request
- Medical and Claim Terminology
- HIPAA Compliance
- Medicaid, Medicare Advantage, Medicare Part A,B,C Knowledge
- Production and Quality Background
- Computer Navigation Proficiency
- Experience calculating and formulating billing amounts
- Ability to keep all company sensitive documents secure
- Ability to demonstrate patience, compassion and empathy
- Proficient in claims management software and healthcare information systems
- Strong knowledge of medical coding and billing processes (CPT,
ICD-10, HCPCS) - Familiarity with insurance regulations and industry standards
- Excellent analytical and problem-solving skills
- Exceptional attention to detail and accuracy
- Effective written and verbal communication abilities
- Ability to prioritize tasks and meet deadlines in a remote work environment
- Group Health Insurance Administration
- Carrier Enrollment and Data Reconciliation
- Ability to demonstrate patience, empathy and compassion
- COBRA and PHI Compliance
- Task-Oriented with Strong Organizational Skills
- Ability to Multitask and Prioritize Workload
- Skilled in Microsoft Excel, Google Sheets, CRM platforms, and other database management systems
- Collaborative team member, experienced in working in a fast-paced, dynamic environment
Timeline
Security Officer
Allied Universal Security Services
04.2024 - Current
Member Service Representative
Conduent (Moved to a Different Department)
08.2021 - 01.2022
Warehouse Worker
Target Distribution Center (FT)
09.2020 - 01.2023
Medical Claims Specialist
Conduent (PT)
04.2020 - 08.2021
Enrollment Eligibility Representative
Alorica (FT)
07.2019 - 04.2020
Cashier
Food Lion (PT)
07.2017 - 07.2019
Pharmacy Tech -
Tidewater Community College
High School Diploma -
Western Branch High School