Angelica Steward
EmblemHealth
Albany,NY
13
years of professional experience
Detail-oriented Healthcare Customer Service and Claims Professional with over 10 years of experience in claims research, reimbursement inquiries, and regulatory compliance. Expertise in investigating claim issues, reviewing documentation, and collaborating with teams for efficient claim resolution. Strong ability to manage priorities in fast-paced environments, leveraging skills in Microsoft Office, Salesforce, and electronic records management systems.
Work History
Customer Service Representative
5 Years 4 Months- Deliver high-quality customer service while managing a high volume of healthcare inquiries.
- Investigated claim discrepancies and analyzed rejected or unresolved claims to ensure timely resolutions.
- Reviewed documentation and verified member eligibility to maintain compliance with healthcare regulations and company policies.
- Collaborate with internal departments to resolve complex claims and reimbursement issues efficiently.
- Review documentation and verify member eligibility while ensuring compliance with healthcare regulations and company policies.
- Delivered high-quality customer service while efficiently managing a high volume of healthcare inquiries.
- Maintain accurate case documentation using Salesforce and Citrix.
CMS Teller
5 Months- Reviewed documentation to ensure accuracy and compliance with regulatory standards.
- Verified data integrity and resolved discrepancies to enhance data reliability.
- Maintained detailed records in compliance with regulatory and security requirements, supporting operational integrity.
- Maintained detailed records while adhering to regulatory and security requirements.
Cash Vault Service Shift Supervisor
2 Months- Supervised daily operations and ensured compliance with company policies and procedures.
- Reviewed operational documentation to ensure accuracy and compliance with standards.
- Investigated operational issues and coordinated resolutions to minimize disruption.
- Streamlined communication and workflow among team members to enhance collaboration.
Operations Manager
6 Years- Oversaw daily operations, staffing, scheduling, and employee performance to ensure smooth workflow.
- Improved operational efficiency through process improvements and team collaboration.
- Analyzed operational reports and documentation for quality and compliance, enhancing accuracy and adherence to standards.
- Conducted training for employees on company procedures and operational best practices, fostering a knowledgeable workforce.
- Resolved escalated customer concerns while maintaining exceptional service standards.
Education
Bachelor of Science - Psychology
Skills
Claims research
Adjudication support
Claims Resolution
Claims Adjudication Support
Claims investigation
Reimbursement Processing
Insurance Verification
Documentation Review
Healthcare documentation
Regulatory Compliance
Salesforce
Citrix
Case management
Records management
Data Entry
Microsoft Excel
Customer Support Techniques
Claims analysis
CRM Software
Core Competencies
Quality Assurance
Problem Solving
Time Management
Multitasking
Communication
Quality control
Timeline
Customer Service Representative
EmblemHealth
04.2021 - CurrentRead More
CMS Teller
Loomis
10.2020 - 03.2021Read More
Cash Vault Service Shift Supervisor
GardaWorld
02.2020 - 04.2020Read More
Operations Manager
TJX Companies, Inc.
02.2014 - 02.2020Read More
Mercy College
Bachelor of Science from Psychology
Read More