Brett Henderson
El Cajon,US
Summary
Administrative and medical professional with over 7 years of experience in claims processing, medical billing, and customer service. Proficient in using Salesforce, Truecare, and Microsoft Office to enhance operational efficiency and support member needs. Aiming to leverage strong analytical skills and a results-oriented approach to drive improvements in healthcare settings.
Professional with extensive experience in managing appeals processes within healthcare sector. Known for strong analytical skills, effective communication, and ability to navigate complex regulatory environments. Proven track record in fostering team collaboration, adapting to changing requirements, and achieving results. Well-versed in conflict resolution, data analysis, and workflow optimization. Reliable and adaptable with focus on delivering high-quality outcomes.
Overview
8
8
years of professional experience
Work History
Customer Service Representative
Serene Healthcare
01.2025 - 04.2025
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
Grievance and Appeals Coordinator
Aetna
07.2023 - 11.2024
- Guide members in resolving inquiries, ensuring seamless service and satisfaction.
- Coordinate PCP changes and assist in locating providers to enhance member experience.
- Facilitate grievance filings and process return mail to maintain efficient operations.
- Verify provider eligibility and claims status to support accurate billing.
- Organize member transportation for medical appointments, ensuring timely access to care.
- Streamlined grievance processes, enhancing member satisfaction and reducing resolution time. Implemented data-driven improvements in PCP changes and eligibility verification.
- Facilitated seamless healthcare access by coordinating transportation for members to medical appointments. Provided empathetic support in resolving complex member inquiries.
- Meticulously processed return mail and managed call tracking systems, ensuring accurate member information and follow-up. Executed precise data entry for provider dispute resolutions.
Healthcare Coordinator
Magellan Healthcare
09.2021 - 04.2023
- Perform incoming admissions from OP Services up to IP Services for Mental Health and Substance abuse
- Help members locate a Mental health or substance abuse provider
- Assist providers with medical billing and ICD 9/ ICD 10 Codes that were approved for use
- Transfer callers to the appropriate EAP Line for employee assistance with an array of issues from legal to medical
Customer Service Representative
Labcorp
10.2020 - 08.2021
- Efficiently handled customer inquiries, ensuring timely resolutions and accurate documentation.
- Verified insurance eligibility, facilitating patient access to necessary therapies.
- Processed complex applications, determining patient eligibility for assistance programs.
- Collaborated with distributors and manufacturers to manage product requests and track shipments.
- Coordinated with distributors and pharmaceutical manufacturers to facilitate product requests, adhering to program guidelines and monitoring shipments.
- Maintained meticulous documentation in tracking systems, ensuring accurate record-keeping and facilitating seamless information flow across departments.
Claims Specialist
Johnson and Rountree Premium
10.2017 - 09.2020
- Take inbound calls from Doctors offices with outstanding debts held by Major insurance carriers like United Healthcare, Cigna and Molina Healthcare
- Advise callers of related claims that have not been processed correctly
- Create and process outstanding spreadsheets of providers with outstanding claims
- Calling outbound to providers offices for status updates on these outstanding claims.Managed inbound calls from healthcare providers, analyzing outstanding debts for major insurance carriers and advising on claim processing errors.
Education
Associates - Political Science
Grossmont College
San Diego, CA01.2015
GED -
Foothills Adult School
San Diego, CA01.2012
Skills
- Microsoft Office
- Outlook
- Truecare
- Salesforce
- Typing
- QNXT
- Medical billing
- Medical coding
- Customer service
- Data entry
- Insurance verification
- Claims processing
- Time management
- Epic
- Data entry proficiency
- Insurance regulations
- HIPAA compliance
- Strong analytical skills
- Medical terminology
- Documentation expertise
Timeline
Customer Service Representative
Serene Healthcare
01.2025 - 04.2025
Grievance and Appeals Coordinator
Aetna
07.2023 - 11.2024
Healthcare Coordinator
Magellan Healthcare
09.2021 - 04.2023
Customer Service Representative
Labcorp
10.2020 - 08.2021
Claims Specialist
Johnson and Rountree Premium
10.2017 - 09.2020
Associates - Political Science
Grossmont College
GED -
Foothills Adult School
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