Ashley Richter
Hopkins,South Carolina
Summary
Dedicated Claim Representative providing skills to prioritize and multi-task in a fast-paced working environment. I successfully work as part of a team to reach personal and business goals. I am also known for successfully handling complex or escalated claims in a prompt time frame. At this time, I am seeking a challenging position within Cigna where I can learn new skills, expand my knowledge and leverage my learnings.
Overview
14
14
years of professional experience
Work History
Claim Representative
Cigna
05.2023 - Current
- Manage a high volume of Prepay claims, ensuring prompt attention to each case using multiple systems such as Proclaim, Trucare, One View, Vipr, and ICMS
- Adjudicate claims to ensure proper benefits, payments, and directions were applied
- Consistently maintains targeted quality scores each month as given by the Prepay Division.
Claim Examiner
Capital Blue Cross
10.2018 - 04.2023
- Assisted claimants, providers and clients with problems or questions regarding claims
- Checked documentation using Facets for appropriate coding, catching errors and making revisions
- Processed claims for payment or forwarded to appropriate personnel for further investigation.
Customer Relationship Specialist Team Lead
U.S. Bank
11.2016 - 10.2018
- Monitored team of 5 Customer Service Representatives to assess knowledge, tone, and adherence to company policy
- Trained new employees on company customer service policies and service level standards
- Assisted agents with handling calls and took over escalated concerns to deliver expert solutions.
Customer Advocate II
Blue Cross Blue Shield of IL
10.2010 - 11.2016
- Consulted with customers through inbound calls to discuss concerns and offer detailed information regarding their insurance policy and benefits
- Performed extensive research and settled all insurance claims with production measures
- Exceeded team goals and collaborated with staff to implement customer service initiatives.
Education
Lockport Township High School
06.2012
Skills
- Detail Oriented
- Proven Ability to Work Independently
- Calm and Professional Under Pressure
- Demonstrate Good Judgement
- Strong organizational Skills
- Courteous with Strong Service Mindset
Timeline
Claim Representative
Cigna
05.2023 - Current
Claim Examiner
Capital Blue Cross
10.2018 - 04.2023
Customer Relationship Specialist Team Lead
U.S. Bank
11.2016 - 10.2018
Customer Advocate II
Blue Cross Blue Shield of IL
10.2010 - 11.2016
Lockport Township High School
Similar Profiles
Rudee FriarRudee Friar
Customer Service Representative at CignaCustomer Service Representative at Cigna
Tiffany LovatoTiffany Lovato
Customer Service Advocate at CignaCustomer Service Advocate at Cigna
Luis GilLuis Gil
Customer Service Representative at CignaCustomer Service Representative at Cigna
TIA WHITETIA WHITE
Senior Enrollment / Medical Billing Specialist at CignaSenior Enrollment / Medical Billing Specialist at Cigna
Jessie RogersJessie Rogers
Community Health Nurse at ACS Services Fort JacksonCommunity Health Nurse at ACS Services Fort Jackson