Ameya Brown
Centene Corporation
Arlington,TX
5
years of professional experience
Detail-oriented and dependable professional with 4+ years of experience in healthcare insurance, customer service, claims support, benefits, authorizations, billing, and dispute resolution. Experienced in reviewing complex information, documenting case activity, preparing correspondence, and communicating clearly with members and internal teams. Proficient in navigating multiple computer systems while maintaining accuracy, confidentiality, and efficiency in fast-paced environments. Known for strong problem-solving, organization, and customer service skills with the ability to quickly learn new systems and processes.
Work History
Member Advocate
3 Years 2 Months- First point of contact for members inquiring about health benefits authorizations billing and payments or explanation of benefits
- Research Complex issues across multiple systems and work with support when needed to deescalate situations
- Meet the performance goals established for the role I am assigned
- Take on new task and assignments
- Provided support for claims processing and inquiries using internal systems.
- Documented customer interactions accurately in the database.
- Maintain comprehensive knowledge of claim processing guidelines, procedures, governing regulations, and compliance requirements
- Prepared and processed acknowledgment and determination letters while maintaining detailed documentation of dispute investigations, actions taken, decisions made, and supporting rationale.
- Maintained compliance with card network rules, escalation procedures, and case documentation standards.
Medical Intern
1 Year 5 Months- Supported patient intake and chart documentation.
- Observed procedures and assisted with clinical tasks.
- Scheduled appointments and handled basic administrative duties.
- Maintained patient confidentiality and HIPAA compliance.
- Assessed patients, documented histories, and updated charts with accurate clinical observations.
- Demonstrated adaptability by swiftly rotating through multiple departments, broadening clinical skills and expertise across various specialties.
Unemployment Claims Specialist
7 Months- Guided claimants through unemployment claims steps and answered questions.
- Reviewed eligibility details and completed weekly benefit certifications.
- Addressed payment problems and helped manage appeal requests.
- Supported claimants while handling confidential information with care.
- Delivered quality service during periods of high economic stress.
- Investigated claimant and employer records, resolving discrepancies through detailed fact-finding and documentation review.
- Maintained up-to-date knowledge of federal and state regulations governing unemployment insurance programs, ensuring compliance at all times.
Education
High School Diploma
Skills
Managed multiple responsibilities and priorities in fast-paced settings.
Developed strong understanding of multiple products and benefit levels within each product line.
Maintained schedule alignment with operating hours
including training period
lunches
and breaks.
Applied HIPAA compliance standards in daily work.
Expanded health benefits knowledge to support accurate guidance.
Conducted inbound and outbound calling to support member and client needs.
Followed healthcare compliance requirements across all interactions.
Communicated using accurate medical terminology.
Timeline
Member Advocate
Centene Corporation
07.2023 - 09.2026Read More
Medical Intern
Healthcare Facility
02.2022 - 07.2023Read More
Unemployment Claims Specialist
Navient Unemployment Claims
07.2021 - 02.2022Read More
Sam Houston High School
High School Diploma
Read More