Bianca Brownlee
Atlanta,GA
Summary
Capable Patient Representative dedicated to providing superior support for patients in need of reliable information regarding insurance coverage, finance options and documentation requirements. Well-versed in scheduling and database management functions for streamlined communication and reduced correspondence backlogs. Excels at identifying client needs and concerns to improve engagement strategies and overall service.
Overview
10
10
years of professional experience
Work History
Member Service Specialist
CareSource Health Plan
02.2017 - Current
- Ensured data integrity and confidentiality by observing strict State Plan guidelines, eligibility requirements, and adhered to HIPPA/PHI Laws Respond to incoming calls as needed to maintain service levels.
- Established open and professional relationships with team members to achieve quick resolutions for various issues.
- Worked different stations to provide optimal coverage and meet production goals.
- Coached team members in techniques necessary to complete job tasks.
- Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
- Built strong relationships with customers through positive attitude and attentive response.
- Conducted training and mentored team members to promote productivity and commitment to friendly service.
- Developed and maintained client databases to track customer service interactions and evaluate service quality.
- Responded to customer inquiries regarding health insurance coverage and policies to assist with informed decision-making.
- Worked with team to identify areas of improvement and devised solutions based on findings.
- Resolved complex issues with tailored solutions, ensuring positive outcomes for both members and the organization.
- Enhanced member satisfaction by providing exceptional customer service and addressing inquiries promptly.
- Conducted thorough research to provide accurate information and recommendations, enabling informed decision-making by members.
Auto Claim Adjuster
State Farm Insurance Inc
01.2015 - 02.2017
- Examined photographs and surveillance and any other documents relating to claims.
- Negotiated with claimants to settle claims.
- Documented all findings in concise reports.
- Issued payouts to claimants.
- Carried and managed consistently heavy project workload through exemplary organizational, time management and collaboration talents.
- Coordinated with local body shops to assign repair jobs and obtained rental vehicles for customers for duration of restoration process.
- Assessed complex claims and accurately determined value of damages.
- Kept current on insurance regulations, laws, policies and procedures.
- Enhanced customer satisfaction by delivering honest advice to policyholders in regards to repair work and body shop processes.
- Demonstrated a high level of initiative and creativity while tackling difficult tasks.
Education
High School Diploma -
Osborne High
Skills
- Operating Systems: Windows 98, 2000, ME, XP, XP Pro, Vista, 7, Windows 8
- Applications: Microsoft Office Suite, Excel, Outlook
- Payment Processing, Call Center Experience, Medical Terminology, Healthcare Recruiting, Data Entry
- Coding, Patient Scheduling, Claims, Billing, Collections and Sales, Enrollment, Appeals & Grievance, Utilization
- Management, ICD-10
- Recruitment
- Claims Handling
- Policy Interpretation
- Insurance regulations knowledge
- Claims Investigation
- Vehicle inspections
- Documentation Management
Customer service standards
Strong empathy
Customer Engagement
Exceptional communication
Youth events in local park/schools
Setting up selfcare/youth events in local parks/schools in Georgia, providing selfcare day,Hair care, Spa care, art ,therapy, and meditating.
Timeline
Member Service Specialist
CareSource Health Plan
02.2017 - Current
Auto Claim Adjuster
State Farm Insurance Inc
01.2015 - 02.2017
High School Diploma -
Osborne High
Similar Profiles
TaJasha HawkinsTaJasha Hawkins
Customer Care Specialist at Caresource Health PlanCustomer Care Specialist at Caresource Health Plan
LATONYA FOSTERLATONYA FOSTER
Customer Service Representative II at Caresource Health PlanCustomer Service Representative II at Caresource Health Plan
Diana JACKSONDiana JACKSON
Customer Service Executive at Caresource Health PlanCustomer Service Executive at Caresource Health Plan
Moziah DavisMoziah Davis
Transmission Analyst at Georgia PowerTransmission Analyst at Georgia Power
Matthew RyanMatthew Ryan
Regional Sales Manager- East at Assa Abloy Americas Residential / Spectrum BrandsRegional Sales Manager- East at Assa Abloy Americas Residential / Spectrum Brands