Bianca Thompson
Greenville,SC
Summary
Dedicated team player adept at managing customer service and claims processing for policyholders. Looking for a long-term position with a growth-oriented company.
Overview
6
6
years of professional experience
Work History
Claims Representative (promotion)
Aetna Medicare
Greenville, SC
09.2024 - Current
- Collaborated with other departments to resolve billing disputes or address customer concerns quickly.
- Processed a high volume of claims efficiently while maintaining quality standards.
- Maintained detailed records of all communication with customers, claimants, providers, and internal departments.
- Adhered to strict guidelines pertaining to confidentiality while handling sensitive personal information.
- Investigated facts, confirmed coverage and liability, negotiated settlements, and determined payments for claims.
- Educated customers on their rights under state and federal regulations governing insurance policies.
Customer Service Representative
Aetna Medicare
Greenville, SC
07.2023 - Current
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Performed administrative tasks such as filing paperwork, updating databases and generating reports.
- Assisted customers with product selection, ordering, billing, returns, exchanges and technical support.
- Resolved customer complaints promptly and efficiently.
- Maintained detailed records of customer interactions, transactions and comments for future reference.
- Resolved complex problems by working with other departments to provide solutions that meet customer needs.
- Informed customers about billing procedures, processed payments, and provided payment option setup assistance.
- Asked probing questions to determine service needs and accurately input information into electronic systems.
Shift Leader
IHS Services
Columbus, OH
05.2021 - 04.2023
- Scheduled team members for shifts based on business needs and customer demand.
- Monitored inventory levels and ordered supplies as needed.
- Provided exceptional customer service and maintained a positive attitude throughout the shift.
- Reviewed time sheets for accuracy before submitting them for payroll processing.
- Monitored employee performance and provided feedback for improvement.
- Communicated effectively with other departments within the organization regarding staffing needs or operational issues.
- Enforced safety guidelines among staff members in order to prevent accidents or injuries from occurring on the premises.
- Supervised the cleaning of dining areas, restrooms, kitchen equipment, and floors in order to maintain a safe and sanitary environment for customers and staff alike.
Claims Representative (remote)
Sunrise Assisted Living
Columbus, OH
02.2019 - 11.2021
- Documented changes in claim statuses using specialized software systems.
- Identified potential fraud indicators during the review process and reported suspicious activity accordingly.
- Ensured timely submission of required documentation from claimants prior to approval of payment.
- Investigated facts, confirmed coverage and liability, negotiated settlements, and determined payments for claims.
Education
Associate of Science - Medical Billing And Coding
Sandford Brown College
Jacksonville, FL09-2013
Skills
- Claims processing
- Billing dispute resolution
- Documentation management
- Medical terminology
- Office equipment operation
- Patient contact
- Insurance plan verification
- Insurance terminology
- Paperwork processing
- Reporting
- Excellent communication
- Data management
- Critical thinking
- Written communication
- Fraud detection
- Skilled in [software]
- Insurance claim forms review
- Goal setting
- Electronic authorization processing
- Documentation processing
Timeline
Claims Representative (promotion)
Aetna Medicare
09.2024 - Current
Customer Service Representative
Aetna Medicare
07.2023 - Current
Shift Leader
IHS Services
05.2021 - 04.2023
Claims Representative (remote)
Sunrise Assisted Living
02.2019 - 11.2021
Associate of Science - Medical Billing And Coding
Sandford Brown College
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