Banita Harris
Augusta,GA
Summary
Communicative customer service professional motivated to maintain customer satisfaction and contribute to company success. History managing large amounts of inbound calls and sustaining satisfactory relationships with customers. Offers skill with CRM systems paired with outstanding active listening and multitasking abilities.
Overview
9
9
years of professional experience
Work History
Data Entry Agent
Sig Track
Raleigh, NC
11.2023 - Current
- Maintained organized files containing electronic copies of all processed documents.
- Generated reports detailing errors or discrepancies in data entry processes.
- Ensured accuracy of data entered by performing regular audits on entries.
- Researched and resolved any issues related to incorrect or incomplete data.
- Analyzed records to identify discrepancies between physical inventory levels and database records.
- Processed large volumes of data quickly and accurately with minimal errors.
- Inputted data into custom software programs and databases accurately and efficiently.
Medical Claims Appeal Specialist
E5 Workflow
Sydney, NSW
12.2021 - 03.2023
- Prepared written summaries of key findings from completed appeal investigations for senior management review.
- Generated comprehensive reports detailing outcomes of appealed claims as well as any corrective actions taken as a result of an investigation.
- Performed quality assurance checks on completed appeal files prior to submission.
- Ensured compliance with all applicable laws, regulations, and standards governing appeals processing.
- Reviewed appeal requests to ensure accuracy of information submitted.
Patient Account Representative
Fresenius Medical Care Holdings Inc.
Metairie, LA
09.2020 - 10.2021
- Researched discrepancies in patient accounts to determine appropriate resolution.
- Analyzed claims denials from third party payers and identified potential solutions for reimbursement.
- Resolved any issues arising from incorrect or incomplete documentation relating to a particular claim.
- Reviewed EOBs statements submitted by insurance companies for accuracy against provider's charges.
- Submitted appeals on behalf of patients when appropriate based on findings from research conducted into denied claims.
- Provided customer service to patients regarding billing inquiries and account information.
- Reached out to patients once insurance was billed in order to obtain payments due.
Claims Representative
Louisiana Children's Medical Center
NEW ORLEANS, LA
12.2019 - 03.2020
- Adhered to strict guidelines pertaining to confidentiality while handling sensitive personal information.
- Reviewed and verified claim information to ensure accuracy of data and compliance with established policies.
- Documented changes in claim statuses using specialized software systems.
- Filed appeals on behalf of customers when necessary after denial of a claim due to insufficient evidence.
- Investigated facts, confirmed coverage and liability, negotiated settlements, and determined payments for claims.
- Ensured timely submission of required documentation from claimants prior to approval of payment.
- Processed a high volume of claims efficiently while maintaining quality standards.
- Managed asset recoveries for claims, including salvage, and subrogation.
- Delivered quality customer service to assigned, insured and claimants throughout entire claims lifecycle to promote service times.
- Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.
MEMBER CUSTOMER SERVICE AGENT/PROVIDER CLAIM SUPPO
WellCare Health Plans Incl
Columbia, SC
11.2016 - 07.2019
- Assisted customers with inquiries regarding products and services through phone, email, and chat.
- Updated customer records in the CRM system accurately with each interaction.
- Documented customer correspondence in CRM to track requests, problems, and solutions.
- Helped clients navigate online systems within established frameworks to obtain services.
- Returned customer calls in established turnaround time to meet company objectives.
- Managed high-volume of inbound and outbound customer calls.
- Informed customers about billing procedures, processed payments, and provided payment option setup assistance.
Phone Banker
Wells Fargo
Columbia, SC
11.2015 - 08.2016
- Provided product information to customers in order to facilitate their decision-making process.
- Maintained accurate records of customer interactions, comments, and complaints in an organized database.
- Resolved disputes between customers and banks while keeping up with the latest regulations governing financial institutions.
- Explained various banking products such as credit cards, loans, mortgages and investments to potential customers.
- Assisted customers with account transfers, balance inquiries, and other banking transactions.
- Identified customer needs and referred them to appropriate departments or resources for further assistance.
- Verified customer identity according to bank policy prior to processing any transaction requests.
- Performed additional duties as assigned by supervisor or manager.
- Answered incoming calls from customers, providing customer service and resolving customer inquiries.
- Capitalized on cross-selling and upselling opportunities to consistently exceed quotas.
- Researched and resolved complex customer inquiries regarding loans, credit and consumer accounts.
Education
High School Diploma -
Joseph S. Clark Preparatory High School
New Orleans, LASome College (No Degree) - Accounting
Delgado Community College
New Orleans, LASkills
- Account updating
- Product Knowledge
- Inbound and Outbound Calling
- Data Entry
- Data Collection
- Complaint resolution
- Medical terminology knowledge
- Conflict Resolution
- Customer Relationship Management (CRM)
- Staff Training
- Escalation management
- Complaint Handling
- Medical Billing
- Claims Processing
- Payment posting
- HIPAA knowledge
- Medical Terminology
- Proficiency in EPIC
- Claim validity determination
Timeline
Data Entry Agent
Sig Track
11.2023 - Current
Medical Claims Appeal Specialist
E5 Workflow
12.2021 - 03.2023
Patient Account Representative
Fresenius Medical Care Holdings Inc.
09.2020 - 10.2021
Claims Representative
Louisiana Children's Medical Center
12.2019 - 03.2020
MEMBER CUSTOMER SERVICE AGENT/PROVIDER CLAIM SUPPO
WellCare Health Plans Incl
11.2016 - 07.2019
Phone Banker
Wells Fargo
11.2015 - 08.2016
High School Diploma -
Joseph S. Clark Preparatory High School
Some College (No Degree) - Accounting
Delgado Community College
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