Bianca Ellis
Tempe,AZ
Summary
A highly experienced Claim Associate looking to expand my customer service, finance and interpersonal skills into different industries; as well as explore and gain new skill sets. With over a decade of customer service experience in various settings. More than capable of excelling on my own, as well as on a team to fulfill assigned metrics.
Overview
11
11
years of professional experience
Work History
Claims Associate
State Farm
03.2024 - 05.2025
- Worked productively in fast-moving work environment to process large volumes of claims.
- Maintained up-to-date knowledge of industry regulations, ensuring compliance in all aspects of claims handling.
- Improved team performance by providing ongoing training and support for Claims Associates on best practices and procedures.
- Managed high-volume claim caseloads, ensuring accurate documentation and adherence to company policies.
- Used jurisdictional references to handle auto property damage, ranging from requesting estimates, making payments and setting up rentals.
- Worked with third party vendors to manage tows, inspections and approve reimbursements
Collections Agent
Omnicare/CVS Health
03.2023 - 02.2024
- Built rapport with patients in long-term care facilities and hospitals by demonstrating understanding of their situation while seeking fair resolutions.
- Processed payments and applied to customer balances.
- Required to maintain an average of 35 accounts as well as a monthly cash collection of 24,000
- Negotiated to collect balance in full.
- Provided exceptional customer service by empathizing with clients'' financial situations while working towards mutually beneficial solutions.
Eligibility Specialist
Aetna(CVS Health)
02.2021 - 11.2022
- Offline position correcting and verifying member’s Mercy Care insurance coverage and medical profile.
- Worked as a team and individually to update member’s information to meet 98 % and above accuracy to avoid denied insurance claims.
- Troubleshooting errors and grievances from outside insurance companies, clinics and fellow colleagues.
- Handled over 85 emails a day regarding medical coverage and correct member information.
- Reduced errors in eligibility determinations by maintaining thorough knowledge of program guidelines and regulations.
- Ensured compliance with local, state, and federal regulations during all phases of the eligibility determination process.
Pharmacy Customer Service Representative
Caremark Prescription Services (CVS Health)
11.2014 - 02.2021
- Worked productively in fast-moving work environment to process large volumes of claims.
- Maintained up-to-date knowledge of industry regulations, ensuring compliance in all aspects of claims handling.
- Improved team performance by providing ongoing training and support for Claims Associates on best practices and procedures.
- Managed high-volume claim caseloads, ensuring accurate documentation and adherence to company policies.
- Used jurisdictional references to handle auto property damage, ranging from requesting estimates, making payments and setting up rentals.
- Worked with third party vendors to manage tows, inspections and approve reimbursements
Education
Associate of Arts - Associates of Arts
Rio Salado Community College
Tempe, AZ07-2025
Skills
- Attention to detail
- 80 WPM
- Numeracy skills
- Time-management
- Critical thinking
- Analytical skills
- Processing transactions/Collections
- Negotiation and interpersonal skills
- Risk-management
- Emotional intelligence
- Ability to multitask
- Maintain accurate records
- Knowledge of MS Office
- Auto Claim Handling
- Regulatory Compliance
- Vendor Management
Accomplishments
➢Trained over 25 plus colleagues on proper HIPAA Procedures and call handling
➢Innovated new training material to new employees to successfully understand tasks
➢Trusted to work after hours without supervision on tasks outside of my normal hours. (Ex: handling incoming emails alone from providers and clinics
Timeline
Claims Associate
State Farm
03.2024 - 05.2025
Collections Agent
Omnicare/CVS Health
03.2023 - 02.2024
Eligibility Specialist
Aetna(CVS Health)
02.2021 - 11.2022
Pharmacy Customer Service Representative
Caremark Prescription Services (CVS Health)
11.2014 - 02.2021
Associate of Arts - Associates of Arts
Rio Salado Community College