Anita Chasteen
Somerset,KY
Summary
Dynamic Tier II Claims Healthcare Representative with 5 years at Maximus Federal, excelling in empathetic communication and active listening. Proven ability to resolve complex claims issues while maintaining HIPAA compliance. Skilled in data entry and prioritizing tasks, ensuring 1st call resolution and customer satisfaction. Advocate for beneficiaries, enhancing their experience with Medicare services.
Overview
8
8
years of professional experience
Work History
Tier II Claims Healthcare Representative
Maximus Federal
09.2020 - Current
- Works remotely, for 5 years
- Gain respect and approval of the customers by establishing rapport and empathy in every call
- Effective listening on every call
- HIPAA compliant on every call
- Relayed information about billing issues, claims, and procedure codes
- Relayed information to Benefits Coordination and Recovery Center concerning the end of another primary coverage to Medicare
- Provided information to providers and SHIP agents on a daily basis
- Assisted callers with information to help them use tools on government apps
- Research and dissect prior authorizations, claim issues, appeals and adding authorizations for beneficiaries
- Escalating items to the Medicare Administrative Contractor concerning, not limited to issues such as lost/stolen checks, suspicious activity, fraud, ordering new ID numbers and address changes
- Referring to other government agencies for assistance in that department
- Multitasking with 2 monitors, scripting, emails, Teams messages and actively listening to the customer to efficiently provide 1st call resolution
- Was webchat representative for 2 years
- Handles 20-30 calls each day
- Uses Internal Support Group for assistance if the problem is not solvable with my assistance
- Serves as an advocate for customers via 3-way calling to pharmacies and suppliers to attempt to resolve the issue or refer the company representative to the Medicare Administrative Contractor for further assistance
- Complete marketing misrepresentation and retro-enrollments
Adult Caregiver
Family Choice
02.2020 - 09.2020
- Assisted with dressing guidance, grooming, meal preparation, and medication reminders.
- Transported individuals to events and activities, medical appointments, and shopping trips.
- Built strong relationships with clients to deliver emotional support and companionship.
- Monitored client vital signs, administered medications, and tracked behaviors to keep healthcare supervisor well-informed.
Data Entry Clerk
Source HOV Services
01.2017 - 05.2017
- Completed data entry tasks with accuracy and efficiency.
- Maintained government clearance to do the assigned tasks
- Keyed information for the Disabled American Veteran's (DAV) and the United States Military
Education
Associate of Science - Medical Assisting And Medical Billing And Coding
National College
Richmond, KY05-2008
Skills
- Former webchat rep
- Former written correspondence rep
- Goal focused
- Insurance, Medicare oriented
- Beneficiary confidentiality
- Data entry
- Phone etiquette with one ear headset
- 10 number keypad
- Active listening
- Always provides empathy
- Clear and concise communication
- Evaluating claims, identifying coverage and determining liability
- Accurately keeps notes in customer's account
- Understanding the specific policies and coverage options
- Prioritizing tasks, meeting training deadlines, and efficiently managing multiple claims
- Using company software for claim information and relays to the customer
- Paying close attention to detail, including dates of service and effective dates
- Adheres to all rules, regulations and company policies
- Communicates effectively via Teams and email
- Trained in durable medical equipment coverage
Languages
English
Full Professional
Timeline
Tier II Claims Healthcare Representative
Maximus Federal
09.2020 - Current
Adult Caregiver
Family Choice
02.2020 - 09.2020
Data Entry Clerk
Source HOV Services
01.2017 - 05.2017
Associate of Science - Medical Assisting And Medical Billing And Coding
National College
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