Anna-Victoria Sanders
Houston,TX
Summary
Customer-focused and performance-oriented service leader with over 10 years of experience in client support, patient services, scheduling, and business management. Proficient in managing high-volume inquiries in both healthcare and business environments, consistently exceeding customer expectations while enhancing operational productivity. Expertise in healthcare systems technical support, fostering long-term customer relationships, and overseeing high-volume accounts. Known for exceptional problem-solving skills and a strong ability to deliver training while ensuring compliance with healthcare standards and regulations.
Overview
10
10
years of professional experience
Work History
Insurance Follow-Up Specialist
GetixHealth
Houston, TX
01.2024 - Current
- Reviewed patient accounts and updated insurance information in the system.
- Identified and corrected errors related to billing, coding, and reimbursement from insurance companies.
- Processed claims for payment according to established procedures.
- Utilized multiple payer websites to obtain detailed information about benefit eligibility and coverage levels.
- Performed reconciliation of payments received against expected reimbursements based on contracted rates.
- Generated reports detailing delinquent accounts receivable balances, aging analysis, denials and rejections.
- Initiated appeals when necessary for denied or underpaid claims as required by contract guidelines.
Health Insurance Advisor
Elevance Health
Houston, TX
05.2023 - 01.2024
- Explained coverage options to potential policyholders, addressing questions and concerns.
- Organized promotional events to increase awareness of various health plans.
- Analyzed clients' needs and financial situations to customize insurance policies.
- Monitored clients' insurance coverage to ensure changing needs were met.
- Spoke to community groups on healthcare coverage and long-term goals.
- Stayed updated on industry trends and best practices.
- Monitored changes in state laws affecting health insurance plans.
- Developed relationships with clients and managed their accounts.
- Created sales presentations based on fact-finding assessments.
- Counseled prospects and policyholders on coverage, limits, and regulations.
Benefits Verification Representative
CareMetx
Houston, Texas
11.2021 - 04.2022
- Conducted systematic eligibility verification checks for patients, documenting prescription drug coverage.
- Oversaw quality assurance for the insurance verification process.
- Communicated with payers to obtain medical eligibility and benefits.
- Completed 25-30 Benefit Investigations daily.
Case Manager
Anthem
02.2019 - 01.2021
- Provided knowledge to providers on claim denials and processed appeals.
- Monitored team progress and enforced deadlines.
Organized and prioritized incoming work orders, optimizing workflows. - Collaborated with management to implement new procedures or policies.
- Delegated daily tasks to optimize productivity.
- Delivered fast, friendly, and knowledgeable service for routine inquiries and complaints.
- Coached, monitored, and motivated new agents.
- Conducted detailed analysis of business requirements and developed test plans.
- Resolved escalated customer complaints.
Collections Team Lead Advisor
Teleperformance
07.2018 - 01.2021
- Monitored accounts to identify outstanding debts.
- Investigated historical data for each debt or bill.
- Contacted clients to inquire about overdue payments.
- Encouraged timely debt payments.
- Processed payments and refunds.
- Updated account status records and reported on collection activity.
- Conducted customer interviews to determine reasons for delinquency.
- Advised customers on debt repayment strategies.
- Reviewed overdue accounts and scheduled follow-up calls.
Senior Individualized Care Coordinator
Cardinal Health
05.2016 - 07.2018
- Conducted systematic eligibility verification checks for patients.
- Oversaw quality assurance for insurance verification.
- Researched and provided solutions for escalated claims and complex situations.
- Ensured compliance with company guidelines and HIPAA laws.
- Monitored enrollment process for prescription-based assistance programs.
- Handled inbound and outbound calls to secure missing account information.
- Verified active insurance plans and patient qualification for assistance.
Clinic Receptionist
Houston Cardiovascular Associates
08.2015 - 04.2016
- Managed front desk operations, including administrative duties.
- Coordinated physician schedules and maintained accurate scheduling.
- Maintained patient medical records and updated files with physician notes.
- Prepared patient admission files and consent forms.
- Ensured patient confidentiality and adhered to HIPAA regulations.
Live Chat Agent
Host Gator
10.2014 - 07.2015
- Supported customers through live chat, resolving website issues.
- Handled multiple customer inquiries simultaneously.
- Provided technical support for website owners.
- Escalated unresolved tickets to the Technology team.
Education
HIGH SCHOOL DIPLOMA -
MARQUE LEARNING CENTER
01.2009
Some College (No Degree) - LCDC
HOUSTON COMMUNITY COLLEGE
Houston, TXSkills
- Insurance Verification
- Client Support
- Problem-Solving
- Insurance regulations knowledge
- Coverage and Authorizations
- Eligibility Determination
- Insurance plan verification
- Claims reporting systems
- Claims Processing
- Electronic Claims Processing
- Claim validity determination
- Insurance Claims
- HIPAA
- Customer Service
Timeline
Insurance Follow-Up Specialist
GetixHealth
01.2024 - Current
Health Insurance Advisor
Elevance Health
05.2023 - 01.2024
Benefits Verification Representative
CareMetx
11.2021 - 04.2022
Case Manager
Anthem
02.2019 - 01.2021
Collections Team Lead Advisor
Teleperformance
07.2018 - 01.2021
Senior Individualized Care Coordinator
Cardinal Health
05.2016 - 07.2018
Clinic Receptionist
Houston Cardiovascular Associates
08.2015 - 04.2016
Live Chat Agent
Host Gator
10.2014 - 07.2015
HIGH SCHOOL DIPLOMA -
MARQUE LEARNING CENTER
Some College (No Degree) - LCDC
HOUSTON COMMUNITY COLLEGE
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