Angela Winder
Claims And Customer Service Professional
Columbus,GA
Summary
Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
15
15
years of professional experience
Work History
Health Insurance Representative
Elevance
Midland, GA
10.2017 - Current
- Answered inbound calls from existing and future policyholders to answer inquiries and discuss insurance options.
- Improved customer satisfaction by efficiently addressing and resolving health insurance inquiries.
- Assisted clients in understanding their coverage options, guiding them towards the most suitable plans for their needs.
- Maintained strict confidentiality while handling sensitive personal data complying with HIPAA regulations.
- Managed high call volume while maintaining exceptional customer service standards, leading to positive feedback from clients.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Contributed to continuous improvement initiatives, suggesting process enhancements aimed at streamlining internal workflows and delivering better service to clients.
- Provided team support by assisting co-workers with their questions in resolving policyholder concerns.
- Handled escalated callers to reach positive outcomes.
- Trained new staff on the company's customer service policy and procedures.
- Exceeded performance metrics consistently, demonstrating commitment to quality service.
Medical Claims Processor
Aflac
Columbus, GA
03.2010 - 07.2017
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Paid or denied 60-70 medical claims daily based on established claims processing criteria.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Processed insurance payments and maintained accurate documentation of payments.
- Reduced errors in claims submissions through meticulous attention to detail and thorough review processes.
- Maintained a high level of customer satisfaction by promptly addressing inquiries and resolving issues related to medical claims.
- Maintained productivity by exceeding quality standards.
Education
GED -
Mississippi Valley State University
Itta Bena, MS 05.2001 -
Skills
Health Insurance product knowledge
Active Listening
Effective Communication
Attention to Detail
Problem-solving aptitude
Customer Complaint Resolution
Strong interpersonal skills
Healthcare system understanding
Claims Processing Expertise
Conflict resolution techniques
Medical Terminology Familiarity
Health Insurance product knowledge
Timeline
Health Insurance Representative
Elevance
10.2017 - Current
Medical Claims Processor
Aflac
03.2010 - 07.2017
GED -
Mississippi Valley State University
05.2001 -
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