Artnetta Patterson
Paterson,NJ
Summary
Claims representative with a proven track record of high productivity and efficient task completion. Expertise in claim investigation, negotiation, and customer service. Strong communication and problem-solving skills enhance claims management and support for policyholders. Committed to delivering accurate and timely resolutions in fast-paced environments.
Overview
11
11
years of professional experience
Work History
Provider Claims Service Representative
AmeriHealth Caritas
New Jersey, New Jersey
04.2023 - Current
- Resolved provider and health plan claim inquiries while monitoring aged pended reports.
- Triaged high volume of inbound calls to ensure timely resolution.
- Maintained expertise in claims processing systems, implementing changes that reduced errors.
- Monitored outstanding inquiries and collaborated with management to address compliance issues.
- Documented files accurately to support payment decisions and compliance efforts.
- Reconciled audit discrepancies by correcting system entries to prevent future issues.
- Escalated medical complaints to qualified professionals for prompt resolution.
PATIENT ACCESS COORDINATOR
RMA
Basking Ridge, NJ
03.2022 - 03.2023
- Triaged high volume of inbound calls and portal inquiries to ensure timely resolution.
- Escalated medical complaints to appropriate professionals for prompt resolution.
- Resolved issues by clarifying concerns, researching solutions, and escalating problems to enhance customer satisfaction.
- Maintained professionalism and composure while managing upset callers, fostering trust and effective communication.
- Provided accurate information and directed calls to relevant departments seamlessly.
PATIENT ACCESS COORDINATOR
THE DERM GROUP
West Orange, NJ
02.2021 - 02.2022
- Obtained and verified insurance information for patients, accurately entering data into Cisco database to streamline billing processes.
- Collected and entered patient intake information into software system, ensuring accuracy for efficient patient processing.
- Promptly and professionally answered, screened, and processed inquiries with strict adherence to confidentiality and company policies/procedures.
- Built strong working relationships with physicians, staff, and departments to enhance collaboration and communication.
- Adapted to changing task demands to maintain operational efficiency and team productivity.
- Showed knowledge of common safety hazards and precautions to establish a safe work environment.
CUSTOMER SERVICE AGENT
ADDISON LEE
Mahwah, NJ
08.2018 - 03.2020
- Engaged clients professionally, addressing inquiries and resolving concerns to enhance customer satisfaction.
- Managed high call volumes, efficiently directing inquiries to appropriate departments for swift resolution.
- Provided support and solutions to customers following established service policies.
- Recorded and processed customer information in company database for efficient service delivery.
- Explained services and pricing details clearly to clients.
- Processed customer orders and prepared accurate invoices.
- Scheduled client transportation to ensure timely arrangements.
- Organized and maintained records by filing, typing, and emailing essential documents to ensure accessibility.
DEBT COLLECTOR
ALLEN, MAXWELL & SILVER
Fair Lawn, NJ
05.2017 - 05.2018
- Collected past due balances through outbound calls, emails, and letters, ensuring timely resolution of accounts.
- Negotiating payments while continuing to build a positive relationship with customers.
- Investigated payment arrears in portfolio, coding debtors accurately to streamline subsequent collection processes.
- Maintained accurate data entry and ensured quota attainment for assigned accounts, contributing to overall collection efficiency.
CUSTOMER SERVICE AGENT
XOGISTIX
Oakland, NJ
08.2015 - 04.2017
- Resolved customer inquiries and escalated calls to ensure timely service issue resolution.
- Managed high volumes of inbound calls while maintaining low call durations to enhance customer satisfaction.
- Partnered with team members to complete tasks efficiently and improve overall service delivery.
- Established quality control measures to guarantee accurate billing information for clean claim submissions.
Education
Lakeland, FL -
SOUTHEASTERN UNIVERSITY
Lakeland, FL01-2009
DIPLOMA - Punta Gorda, FL
CHARLOTTE HIGH SCHOOL
Punta Gorda, FL01-2004
Skills
- Claims adjudication
- Claims management
- Claims documentation
- Call handling
- Customer management
- Microsoft Office Suite
- Problem solving
- Critical thinking
- Effective communication
- Professional demeanor
Timeline
Provider Claims Service Representative
AmeriHealth Caritas
04.2023 - Current
PATIENT ACCESS COORDINATOR
RMA
03.2022 - 03.2023
PATIENT ACCESS COORDINATOR
THE DERM GROUP
02.2021 - 02.2022
CUSTOMER SERVICE AGENT
ADDISON LEE
08.2018 - 03.2020
DEBT COLLECTOR
ALLEN, MAXWELL & SILVER
05.2017 - 05.2018
CUSTOMER SERVICE AGENT
XOGISTIX
08.2015 - 04.2017
Lakeland, FL -
SOUTHEASTERN UNIVERSITY
DIPLOMA - Punta Gorda, FL
CHARLOTTE HIGH SCHOOL