Professional with strong background in medical claims evaluation and resolution. Adept at analyzing complex claims, ensuring compliance with regulations, and providing accurate assessments. Known for excellent collaboration, adaptability, and results-driven approach. Possess skills in claims processing, customer service, and conflict resolution. Reliable team player with commitment to achieving optimal outcomes.
Hi, I’m
Aysha Watts
Columbia,SC
Summary
Overview
6
years of professional experience
Work History
Recruiting Solutions
Medical Claims Adjuster
06.2021 - 07.2024
Job overview
- Analyzed policy details along with supporting documents provided by healthcare providers to make informed decisions on claims approvals or denials.
- Resolved complex claims issues for expedited processing and resolution.
- Managed high volume caseloads, prioritizing urgent and sensitive cases for immediate attention.
- Implemented quality control measures to reduce errors and improve overall accuracy rate in claims processing.
- Maintained strict compliance with HIPAA regulations, safeguarding patient privacy throughout the claim evaluation process.
- Improved customer satisfaction with timely and accurate claim settlements.
Evicore Healthcare
Intake Representative
03.2020 - 06.2021
Job overview
- Managed high call volumes while maintaining a professional demeanor, ensuring a positive experience for all callers.
- Enhanced customer satisfaction by efficiently processing intake forms and accurately entering data into the system.
- Served as a liaison between clients and healthcare providers, fostering strong relationships that facilitated seamless service coordination.
- Conducted thorough assessments of client needs, connecting them with appropriate resources and services within the organization.
- Reduced wait times for clients by promptly addressing inquiries and providing clear, concise information regarding services.
- Handled sensitive client situations with compassion while maintaining adherence to organizational policies and procedures.
- Provided accurate insurance verification for clients, ensuring proper coverage was in place prior to service delivery.
- Maintained up-to-date knowledge of industry trends and changes in regulations, ensuring accurate information was shared with clients at all times.
- Exceeded performance metrics regularly, demonstrating consistent dedication to quality work and customer satisfaction.
Apple
Apple Technical Support Agent
11.2018 - 03.2020
Job overview
- Enhanced customer satisfaction by providing timely and accurate responses to inquiries through chat support.
- Retained detailed records of all chat support interactions, ensuring optimal documentation for quality assurance purposes.
- Conducted thorough research to provide accurate information, ensuring prompt resolution of customer concerns.
- Resolved technical issues for customers by utilizing comprehensive knowledge of company products and services.
- Collaborated with team members to share best practices for handling complex inquiries and improving overall performance.
- Utilized CRM systems proficiently for tracking customer interactions, updating records, and managing follow-up actions as necessary.
- Expedited issue resolution with efficient multitasking and prioritization of multiple chat conversations simultaneously.
- Analyzed issues to identify troubleshooting methods needed for quick remediation.
- Assisted customers in identifying issues and explained solutions to restore service and functionality.
Education
Southern New Hampshire UniversityHooksett, NH
Bachelor of Science from Business Management, Business Management
05-2028
University Overview
Skills
- Responding to Difficult Customers
- Medical Terminology
- HIPAA compliance awareness
- Type 50 WPM
- Customer Account Management
- Effective communication
- Problem solving prowess
- Data Entry and Maintenance
- Time management mastery
- CMS Knowledge
- Customer Service
- Healthcare billing
- Insurance regulations compliance
- Empathy
- Claims analysis expertise
- Technical Proficiency
Timeline
Medical Claims Adjuster
Recruiting Solutions
06.2021 - 07.2024
Intake Representative
Evicore Healthcare
03.2020 - 06.2021
Apple Technical Support Agent
Apple
11.2018 - 03.2020
Southern New Hampshire University
Bachelor of Science from Business Management, Business Management
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