Alyssa Little
Florence,SC
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
12
12
years of professional experience
Work History
Claims Benefit Specialist
Allstate Insurance Co
Florence, SC
04.2021 - Current
- Investigated potential fraud cases involving false claims submitted by customers.
- Reviewed and evaluated customer claims for accuracy, completeness and compliance with company policies.
- Documented claim processing activities in accordance with established procedures.
- Identified discrepancies between actual payments made versus what was authorized by the insurer.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Collaborated with other departments to resolve billing disputes or address customer concerns quickly.
Patient Service Representative
Change Healthcare
Florece, SC
10.2017 - 04.2024
- Assisted with scheduling follow-up appointments according to provider availability.
- Prepared letters and documents for mailing as requested by supervisor or physician staff.
- Informed patients about payment options, billing policies, and procedures related to their visit or procedure.
- Inputted patient demographic data into electronic health record system.
- Answered incoming calls in a professional manner.
- Provided customer service by answering patient questions and addressing concerns.
- Verified insurance information, collected payments, and scheduled appointments.
- Adhered to HIPAA regulations when handling confidential patient information.
- Documented processes related to the adjudication of medical claims for use as reference materials.
- Performed audits of medical claims submitted by providers to ensure accuracy and compliance with established regulations.
- Maintained a database of all medical claims received from insurance companies.
- Reviewed, analyzed, and processed medical claims for accuracy and completeness.
- Reviewed, analyzed and approved complex medical claims for accuracy and compliance with state and federal regulations.
- Processed medical claims according to established guidelines, including verifying authorization and coding requirements.
- Reviewed medical claims for accuracy and completeness, verifying patient eligibility and coding.
Patient Registration Representative
Medtronic
Florence, SC
05.2016 - 05.2017
- Updated patient information in database regularly to ensure accuracy of records.
- Assisted patients with completion of forms needed for admission process.
- Handled incoming faxes related to admissions, discharges, transfers, pre-certifications, authorizations.
- Entered patient data into electronic medical record system accurately and efficiently.
- Resolved discrepancies between billing systems and patient accounts quickly and accurately.
- Maintained confidentiality of patient information in accordance with HIPAA regulations.
- Greeted patients and answered questions regarding registration process.
- Completed prior authorization requests within required timeframes and ensured appropriate documentation was obtained.
Customer Service Representative II
Sykes
Florence, SC
08.2012 - 04.2016
Education
Associate of Science -
Southern New Hampshire University
Hooksett, NHSome College (No Degree) - Administrative Assistant
Professional Medical Training Academy
Florence Sc Skills
- Claim investigation
- Insurance knowledge
- Policy Interpretation
- Eligibility Determination
- Customer Service
- Data Entry
- Electronic authorization processing
- Medicaid knowledge
- Claims Processing
- Organizational Skills
Timeline
Claims Benefit Specialist
Allstate Insurance Co
04.2021 - Current
Patient Service Representative
Change Healthcare
10.2017 - 04.2024
Patient Registration Representative
Medtronic
05.2016 - 05.2017
Customer Service Representative II
Sykes
08.2012 - 04.2016
Associate of Science -
Southern New Hampshire University
Some College (No Degree) - Administrative Assistant
Professional Medical Training Academy