Andrea Killingsworth
Cocoa
Summary
Claims Benefits Specialist with Aetna, skilled in claims analysis and time management. Proven track record of reducing processing errors and enhancing customer satisfaction through effective problem-solving and attention to detail. Adept at multitasking in high-pressure environments, ensuring compliance and confidentiality while achieving performance targets consistently.
Overview
11
11
years of professional experience
Work History
Claims Benefits Specialist
Aetna
02.2024 - Current
- Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
- Settled complex claims fairly by applying critical thinking, negotiation skills, and detailed knowledge of insurance policies.
- Reduced claim processing errors by conducting thorough investigations and accurately interpreting policy details.
- Achieved performance targets consistently through attention to detail, effective time management, and strong decision-making abilities.
- Analyzed claim documents to ensure accuracy and compliance, mitigating risk of financial loss.
- Maintaining patient confidentiality by adhering to HIPPA regulations and diligently updating records as needed.
Customer Service Representative
Aetna Better Health of Florida Medicaid
11.2021 - 02.2024
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
- Improved resolution time with effective problem-solving for customer complaints.
- Maintained patient confidentiality by adhering to HIPPA regulations and diligently updating records as needed.
Patient Services Representative
Health First Medical Group
01.2020 - 11.2020
- Maintained patient confidentiality by adhering to HIPAA regulations and diligently updating records as needed.
- Implemented effective time management strategies that allowed me to balance multiple responsibilities, resulting in improved productivity and patient satisfaction.
- Managed high call volume, prioritizing urgent issues and directing calls appropriately for optimal resolution.
- Conducted pre-registration tasks including verifying insurance eligibility requirements were met before scheduled appointments.
- Increased efficiency of office operations through proper management of medical records and filing systems.
- Took copayments and compiled daily financial records.
- Assisted patients in filling out check-in and payment paperwork.
- Assisted with billing inquiries and insurance verification, resulting in a smoother financial experience for patients.
- Greeted and assisted patients with check-in procedures.
- Verified patient insurance eligibility and entered patient information into system.
- Processed payments using cash and credit cards, maintaining accurate records of transactions.
- Answered incoming calls, scheduled appointments and filed medical records.
- Provided exceptional customer service to build strong relationships with patients, leading to increased loyalty and return visits.
VPK & Preschool Teacher's Aide /Aftercare Teacher
Merritt Island Christian School
01.2014 - 01.2020
- Developed strong relationships with parents and caregivers, providing regular updates on their child''s progress and addressing any concerns proactively.
- Developed weekly lesson plans and activities to engage children and promote learning.
- Maintained organized, fun and interactive classroom to help children feel safe.
- Sanitized toys and play equipment each day to maintain safety and cleanliness.
- Designed creative lesson plans that incorporated hands-on activities and interactive learning experiences to foster curiosity and engagement in young learners.
- Ensured a safe and nurturing environment for all students, adhering to health and safety guidelines in the classroom.
- Contributed to the successful implementation of school-wide initiatives by collaborating with colleagues on curriculum development, professional development, and other projects.
Education
No Degree - FCCPC Certificate / VPK Aide Certification
Eastern Florida State College
Cocoa, FL05-2017
Associate of Arts - General Studies
Eastern Florida State College
Cocoa, FL05-2012
Skills
- Claims analysis
- Microsoft office
- Claim investigation
- Confidentiality handling
- Time management
- Multitasking
- Attention to detail
- Organizing and prioritizing work
Timeline
Claims Benefits Specialist
Aetna
02.2024 - Current
Customer Service Representative
Aetna Better Health of Florida Medicaid
11.2021 - 02.2024
Patient Services Representative
Health First Medical Group
01.2020 - 11.2020
VPK & Preschool Teacher's Aide /Aftercare Teacher
Merritt Island Christian School
01.2014 - 01.2020
No Degree - FCCPC Certificate / VPK Aide Certification
Eastern Florida State College
Associate of Arts - General Studies
Eastern Florida State College
Similar Profiles
Revathi MallineniRevathi Mallineni
Data Analyst at AetnaData Analyst at Aetna
AMANDA MORROWAMANDA MORROW
Claims Processor at AetnaClaims Processor at Aetna
Kellie ThinerKellie Thiner
Senior Complaint and Appeals Coordinator at AetnaSenior Complaint and Appeals Coordinator at Aetna
Aaron MaranaAaron Marana
Lead Machinist at Renzetti - Quality Fly Tying Vises, Tools And Accessories ManufacturerLead Machinist at Renzetti - Quality Fly Tying Vises, Tools And Accessories Manufacturer
Lauren MarquezLauren Marquez
Server at Kelsey’s PSJServer at Kelsey’s PSJ