Summary
Overview
Work History
Education
Skills
Personal Notes
Seeking Employment
Timeline
Generic

Brandi McClain

Owings Mills,MD

Summary

Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand. Hardworking employee with customer service, multitasking and time management abilities. Devoted to giving every customer a positive and memorable experience.

Overview

18
18
years of professional experience

Work History

Insurance Verification Specialist

Medstar Health
09.2023 - 01.2024
  • Communicated with insurance companies to obtain information and insurance verification through electronic verification system and to assure quality patient care and collection of co pays, deductibles if applicable
  • Managed insurance verification authorizations with their automated systems to check the eligibility
  • Confirmed authorizations if needed
  • Managed doing the diagnostic codes for eight different Medstar hospitals from the beginning to end of the process
  • Issued Cash posting payments for Outpatient Hospital Workers Compensation and physical therapy for the Medstar Hospitals.

Customer Service Representative 1

Kaiser Permanente
01.2023 - 08.2023
  • Advised federal members on health benefit inquiries
  • Assisted Traditional HMO, DHMO, Employer Group Members, and Health exchange members in California with their eligibility and benefits
  • Assigned medical records numbers to Newborns and new members
  • Transferred memberships between Northern and Southern California
  • Answered provider’s calls regarding member’s eligibility and benefits
  • Processed Premium billing Payments and Auto Pay
  • Advice member of Benefits, Co-insurance, Copays, and Deductibles.

Claims Liability Examiner

CorVel Corporation
02.2022 - 08.2022
  • Accessed and paid Liability Claims for Montgomery County Vehicles Accident Claims
  • Interviewed Insured and non-insured for accident documentation
  • Reviewed Police reports, photos, and videos related to accidents
  • Issue and authorize payments for vehicle repairs
  • Assigned Subrogation
  • Determined Liability based on loss documentation evidence
  • Issue salvage and total loss payments.

Benefits Verification Specialist

Lash Group
10.2020 - 02.2021
  • Verified benefits with Various insurance companies
  • Obtained prior authorizations for public and private insurance companies for specialty medications
  • Determined coverage allowances based on eligibility
  • Verified if a member’s coverage for medication is through their pharmacy or medical benefits
  • Interpreted benefit program requirements and guidelines when determining eligibility
  • Confirmed benefits and obtained authorization for Medicare and Medicaid members
  • Tri-Care members
  • Confirmed dual medical coverage.

Member Service Specialist

Broad-Path LLC
10.2019 - 02.2020
  • Answered inbound calls from a wide range of members, welcoming callers in a polite, friendly, and professional manner
  • Utilized various technical systems, including Microsoft 10, Omni, Fusion, Paces, Cisco, and Avaya Phone systems
  • Assisting individuals in establishing their entitlement to receive benefits
  • Maintained elevated levels of professionalism and product knowledge across providers
  • Assisted members with making Premium payments
  • Managed continuous delivery of top-quality membership support.

Member Service Representative

CorVelFidelis Care of New York
03.2012 - 06.2018
  • Evaluated customer account information to assess current issues and determined potential solutions
  • Assisted individuals in establishing their entitlement to available programs
  • Advised members Of NYS of Health plans
  • Assisted in maintaining accurate records by verifying and updating member account information
  • Managed customer conflicts and challenging situations by staying calm and accessing.

Claims Representative

GEICO
03.2006 - 02.2012
  • Determined Liability in Auto claims with no or Minor Bodily Injury
  • Verified details with policyholders and requested additional information
  • Provided quality customer service to all assigned, insured, and claimants throughout the claims process to deliver timely customer service
  • Identified suspicious losses, immediately contacting the Theft and Loss Department to conduct further investigations
  • Assigned Subrogation examiners to recover the Policyholder’s Deductible.

Education

Associate of Arts in Business Administration -

University of Phoenix

Pursuing bachelor’s degree in Cybersecurity Technology -

University of Maryland Global Campus

Skills

  • Customer Service
  • Payment Processing
  • Inbound Customer Service
  • De-Escalation Techniques
  • Complaint Resolution
  • Adaptability
  • Professional Telephone Demeanor
  • Attention to Detail
  • Multitasking

Personal Notes

Took time to care for a family member from June/2018 to October 2019

Seeking Employment

  • August 2022, December 2023
  • March 2021, October 2021

Timeline

Insurance Verification Specialist

Medstar Health
09.2023 - 01.2024

Customer Service Representative 1

Kaiser Permanente
01.2023 - 08.2023

Claims Liability Examiner

CorVel Corporation
02.2022 - 08.2022

Benefits Verification Specialist

Lash Group
10.2020 - 02.2021

Member Service Specialist

Broad-Path LLC
10.2019 - 02.2020

Member Service Representative

CorVelFidelis Care of New York
03.2012 - 06.2018

Claims Representative

GEICO
03.2006 - 02.2012

Associate of Arts in Business Administration -

University of Phoenix

Pursuing bachelor’s degree in Cybersecurity Technology -

University of Maryland Global Campus

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Brandi McClain