Alleya Clarke
Orange
Summary
Motivated Client Service Representative with proven administrative, problem-solving and customer relations skills. Collaborative and driven with clear focus on putting clients first and supporting team needs. Well-organized, flexible, and computer-savvy.
Overview
11
11
years of professional experience
Work History
Client Service Specialist
Zelis
Morristown
11.2019 - Current
- Serve as primary point of contact for mid- to high-volume healthcare clients, managing billing inquiries, payment issues, and escalations across the revenue cycle
- Build and maintain strong relationships with client billing teams, ensuring timely issue resolution and high client satisfaction
- Analyze performance metrics and identify trends to recommend and implement process improvements
- Collaborate with cross-functional teams (operations, compliance, and billing) to optimize workflows and service delivery
- Improve turnaround times and reduce recurring issues through proactive problem-solving and communication
- Train and onboard new Client Service Specialists (CSS), providing guidance on systems, workflows, and best practices to ensure successful integration and consistent performance
Customer Care Specialist
Zelis
Morristown
10.2018 - 11.2019
- Managed high-volume inbound and outbound calls, providing education to healthcare providers and members to drive first-call resolution
- Utilized CRM systems to verify claimant information and resolve account discrepancies efficiently
- Achieved and exceeded call center KPIs by 15%, including quality assurance, productivity, and compliance standards
- Ensured full HIPAA compliance while handling sensitive patient and provider information
- Accurately documented interactions to reduce claim errors and minimize rework
Claims Benefits Specialist
QPharma
Morristown
12.2016 - 10.2018
- Performed pharmacy benefit verifications for commercial and government payers, improving patient access to medications
- Educated patients on prescription coverage, formularies, and out-of-pocket costs
- Processed and corrected claims using Titanium and OMS systems, enhancing data accuracy
- Reported adverse events and product quality complaints in accordance with FDA guidelines
Accounts Receivable Associate
Vision Associates
Warren
06.2015 - 06.2016
- Processed insurance claims, reviewed EOBs, and managed denial submissions within billing cycle timelines
- Followed up with insurance carriers to resolve discrepancies and maximize reimbursements
- Generated monthly AR reports, identifying trends and outstanding balances for leadership review
- Ensured compliance with billing regulations and reporting standards
Education
Medical Billing and Coding - Health Care Management
Everest Institute
South Plainfield, NJSkills
- Client Relationship Management
- Account Management
- Revenue Cycle Management
- Claims Analysis & Resolution
- Healthcare Billing & Coding
- Process Improvement
- Cross-Functional Collaboration
- Data Analysis & Reporting
- Microsoft Office
- CRM Systems
- Titanium
- OMS
- Electronic Medical Records (EMR)
- Client relationship management
Timeline
Client Service Specialist
Zelis
11.2019 - Current
Customer Care Specialist
Zelis
10.2018 - 11.2019
Claims Benefits Specialist
QPharma
12.2016 - 10.2018
Accounts Receivable Associate
Vision Associates
06.2015 - 06.2016
Medical Billing and Coding - Health Care Management
Everest Institute