Breanna McCumber
Katy,TX
Summary
Detail-oriented and adaptable Healthcare Administration Specialist with over 10 years of experience. Supporting insurance claims, billing, skilled in EOBs, maintaining compliance with HIPPA And auditing records and contracts.
Overview
11
11
years of professional experience
Work History
Claims Representative/ CSR
Senture- Triwest
11.2024 - 09.2025
- Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Conducted detailed assessments of claims documents, ensuring accuracy and completeness before submission for approval.
- Developed in-depth understanding of insurance policies and procedures.
- Streamlined data entry processes, improving efficiency in claim file management.
Emergency Service Program Coordinator
HHSC
08.2024 - 01.2025
- Coordinated and managed emergency service programs, ensuring efficient response and resource allocation to enhance public safety and service delivery.
- Provided exceptional customer service to program participants through prompt response times and attentive assistance with inquiries or concerns.
- Facilitated regular meetings with team members to discuss progress updates, address challenges, and brainstorm solutions for ongoing success.
- Produced monthly reports using advanced Excel spreadsheet functions.
- Used statistical methods to analyze data and generate useful business reports.
Leasing Consultant
Penn Apartment Staffing
01.2024 - 07.2024
- Facilitated property leasing processes by conducting tours, managing tenant applications, and maintaining high occupancy rates through effective communication and customer service.
Customer Service Representative
Navient
07.2023 - 12.2023
- Delivered prompt and accurate information to customers in a high-volume inbound call and email center, ensuring courteous and professional communication.
- Guided consumers in enrolling for government programs online, effectively communicating benefits and services available to them.
- Utilized multiple systems, including Nlad, SNOW, and Excel, for troubleshooting and logging interactions, demonstrating quick adaptability and proficiency.
Enrollment Consultant
Randstad
07.2022 - 12.2023
- Collaborated with the sales team to consistently meet or exceed personal sales quotas through effective communication and teamwork.
- Collected and qualified candidate information for various programs, ensuring applications were accurately completed with all necessary supporting materials.
- Managed enrollment processes by entering, updating, and reviewing customer data, while addressing inquiries and providing detailed information on requirements and policies.
- Offered guidance and recommendations to prospective candidates, listening to and understanding their needs to suggest appropriate service options.
Customer Service Call Center Representative
Amazon
08.2017 - 02.2018
- Responded to customer inquiries and facilitated order placements via chat, phone, and email, ensuring seamless communication and customer satisfaction.
- Delivered troubleshooting and technical assistance, resolving customer issues efficiently and enhancing overall service quality.
Customer Service Sales Representative
Kmart
02.2015 - 08.2016
- Enhanced customer loyalty and increased store traffic by effectively communicating sales and promotions to customers.
- Facilitated customer account setup and navigation within various applications, providing troubleshooting support and guidance for optimal app utilization.
- Managed order processing, including generating quotes, producing sales documents, and ensuring timely billing, payment processing, and delivery coordination.
Customer Service Representative
DHL
01.2016 - 06.2016
- Managed high-volume inbound call flow, consistently answering over 80 calls daily while maintaining professionalism and knowledgeable service.
- Resolved customer complaints effectively by clarifying issues, identifying root causes, and achieving complete satisfaction, consistently meeting or exceeding benchmarks for speed, accuracy, and volume.
- Coordinated with vendors to secure necessary shipment documentation, supporting both inbound and outbound logistics processes.
Education
High School Diploma -
San Diego High School
San Diego, CASkills
- Time management
- Claims investigation
- Microsoft office
- Data entry
- Insurance claims review
- Appointment scheduling
Accomplishments
- Conflict Resolution - Responsible for handling customer account inquiries, accurately providing information to ensure resolution of product/service complaints and customer satisfaction.
Timeline
Claims Representative/ CSR
Senture- Triwest
11.2024 - 09.2025
Emergency Service Program Coordinator
HHSC
08.2024 - 01.2025
Leasing Consultant
Penn Apartment Staffing
01.2024 - 07.2024
Customer Service Representative
Navient
07.2023 - 12.2023
Enrollment Consultant
Randstad
07.2022 - 12.2023
Customer Service Call Center Representative
Amazon
08.2017 - 02.2018
Customer Service Representative
DHL
01.2016 - 06.2016
Customer Service Sales Representative
Kmart
02.2015 - 08.2016
High School Diploma -
San Diego High School
Similar Profiles
Jabria SweeneyJabria Sweeney
Customer Service Representative II at MAXIMUS/Triwest Healthcare AllianceCustomer Service Representative II at MAXIMUS/Triwest Healthcare Alliance
Sarah MabrySarah Mabry
Provider Credentialing Specialist at TriWest Healthcare AllianceProvider Credentialing Specialist at TriWest Healthcare Alliance
Corey ImperatriceCorey Imperatrice
Human Capital Coordinator at TriWest Healthcare AllianceHuman Capital Coordinator at TriWest Healthcare Alliance
KOSSI BATTAHKOSSI BATTAH
Insurance Executive at Lincoln Insurance Brokerage, LLCInsurance Executive at Lincoln Insurance Brokerage, LLC
Sean OrrSean Orr
Designer at Watts Pool CompanyDesigner at Watts Pool Company