Brianna Curry
Houston,TX
Summary
Persuasive Advocate known for high productivity and efficient task completion. Skilled in legal research, client advocacy, and case management, ensuring thorough preparation and strong representation in various legal settings. Excel at communication, negotiation, and critical thinking, leveraging these soft skills to successfully navigate complex legal landscapes and advocate effectively for clients' interests.
Dedicated and adaptable professional with a proactive attitude and the ability to learn quickly. Strong work ethic and effective communication skills. Eager to contribute to a dynamic team and support organizational goals.
Proactive and versatile professional with a dedication to quickly adapting to new challenges. Strong problem-solving abilities and a proven track record of fostering strong relationships with clients and team members. Focused on supporting team success and achieving positive results.
Results-driven individual with a solid track record in delivering quality work. Known for excellent communication and teamwork abilities, with a commitment to achieving company goals and delivering exceptional service. Passionate about continuous learning and professional development.
Experienced and dependable general worker with a proven track record of efficiently completing tasks in various settings. Skilled in manual labor, equipment operation, and maintaining a clean and organized workspace. Safety-conscious with a strong work ethic and the ability to adapt to different environments. Ready to contribute to a dynamic team and make a positive impact.
Resourceful Medical Claims Specialist recognized for high productivity levels and efficient task completion. Specialize in claims processing, medical coding, and insurance regulations compliance, ensuring accuracy and timely submissions. Excel in communication, problem-solving, and organization, skills that contribute to effective dispute resolution and customer satisfaction.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Medical Claims Specialist
Cigna Healthcare
06.2023 - Current
- Answer inbound calls from members with questions about medical claims, benefits, eligibility, and prior authorization
- Call center (remote)
- Take calls back-to-back while toggling through several applications on multiple screens
- Committed to providing customers with a seamless and exceptional experience
- Responsible for supporting multiple lines of business and is equipped to handle a wide range of inquiries, from the simple to the complex
- Strive to be a one-stop-shop for our customers, reducing the need for transfers and minimizing wait times
- Take ownership of every inquiry and issue, and dedicated to resolving them on the first contact whenever possible
- Educating customers on disease management programs and making personalized recommendations for healthy living initiatives that cater to their specific needs
- Prioritizing customer satisfaction and well-being, we aim to build long-lasting, trust-based relationships with our client
- Supports and processes authorization requests for services in accordance with the insurance prior authorization list and routes to the appropriate clinical reviewer
- Remain customer-focused at all times to meet tailored needs, providing positive outcomes for our member's well-being
- Resolve customer complaints through independent problem-solving skills and one-call resolution
- Understanding and striving to meet or exceed call center metrics while providing accurate information to callers with a courteous and professional demeanor
- Enjoy a work-from-home lifestyle where you can virtually connect with coworkers and customers
- Determination of payments and claims related to medical and dental procedures and office and hospital visit costs
- Educate patients on disease management programs and make recommendations on the right healthy living programs for their needs
- Keeping the patient and their loved ones up to date on test results, diagnoses, treatments available, etc
- Speak with doctors, nurses, and administrators on the patient's behalf
- Providing patients with all the information they need to make informed decisions about their healthcare
- Knowledge of HCPC codes
- Knowledge of ICD-10 codes
- Respond to customer queries in a timely and accurate way, via phone, email or chat
- Ability to multi-task, prioritize, and manage time effectively
- Conducted in-depth research to assist patients in understanding their medical conditions, treatment options, and healthcare coverage options, ensuring they receive optimal care and support
- Effectively communicated complex medical information to patients, families, and healthcare providers to ensure seamless care coordination
- Analyzed patient data and research findings to identify potential issues and develop solutions to address patient needs
Provider Relations Specialist
Evernorth Behavioral Health
12.2021 - 12.2023
- Collaborated with healthcare providers to establish and maintain positive relationships, ensuring effective communication and problem resolution
- Call center (remote)
- Conducted regular provider outreach and education sessions to enhance understanding of Evernorth Behavioral Health programs, policies, and procedures
- Managed a portfolio of providers, addressing inquiries, concerns, and escalations in a timely and professional manner
- Assisted providers with claims inquiries, billing issues, and reimbursement processes, ensuring accurate and timely resolution
- Conducted provider network analysis to identify gaps in coverage and worked with the network development team to recruit new providers as needed
- Participated in the development and implementation of provider training programs to improve provider satisfaction and enhance the quality of services delivered
- Collaborated with internal teams, including claims, customer service, and utilization management, to ensure seamless coordination of care and resolution of provider-related issues
- Maintained accurate and up-to-date provider records, ensuring compliance with regulatory requirements and internal policies
- Monitored provider performance metrics, identified areas for improvement, and implemented strategies to enhance provider satisfaction and engagement
Stand Leader
Constellation Field
Houston, TX
08.2021 - 08.2023
- Unloading equipment from trucks and setting up venues for events, including chairs and building stages
- Working as ushers and ensuring that seating arrangements adhere to fire code regulations
- Operating cash registers
- Ensuring the event hall is clean and organized
- Adhering to event safety standards
- Ensuring excellent levels of customer service
- Undertaking security duties
- Assuming the role of Ticket Taker and welcoming guests
- Setting up lighting and sound equipment
- Working at a concession stand and serving food and drinks
- Dispensing useful information to event-goers
- Inspecting equipment for damage after use and checking it against an inventory list
- Packing up equipment when the event is completed
Claims and Billing Specialist
Delta Dental
05.2020 - 06.2023
- Company Overview: GA
- Verifying the patient's dental insurance benefits
- Call center (remote)
- Performs intake of calls from members or providers regarding services via telephone, fax, mail and email
- Assign members to dental office
- Explaining insurance benefits to patients
- Protect the confidentiality of member information and adhere to company policies regarding confidentiality
- Provide procedure code copay's to dentist and patients
- Determines covered insurance losses by studying provisions of a policy or certificate
- Establishes proof of loss by studying documentation and assembling additional information from outside sources
- Documents specific claims by completing and recording forms, reports, logs, and records
- Analyzes insurance claims to prevent fraud
- Prepares reports by collecting, analyzing, and summarizing information
- Ensures legal compliance by following company policies, procedures, and guidelines, as well as state and federal insurance regulations
- Maintains quality customer service by following customer services practices and responding to customer inquiries
- Provides legal support by assembling documentation for settlement action
- Protects operations by keeping claims information confidential
- Maintains a good relationship with insurance departments
- Send invoices and account updates to clients
- Keep an accurate record of client accounts and outstanding balances
- Validate debit accounts to ensure the credibility of payments
- Issue receipts for received payments
- Address and solve client questions and issues
- Securely handle client data and payment information
- Provide regular, accurate reports of billing data
- GA
Fundraising Specialist
Special Olympics
02.2019 - 12.2022
- Business to Business sales
- Cold calling
- Call center (remote)
- Manage sales within a defined territory and/or geography
- Gather key information to update the CRM system and assign a nurture path and follow-up strategy
- Consult with customers to gather information and make recommendations for their communication and entertainment needs for their business
Fraud Specialist
Bank of America
Morgantown, WV
05.2018 - 11.2022
- Company Overview: Morgantown, WV
- Strong understanding of banking regulations and compliance procedures
- Proficient in conducting fraud investigations and analyzing complex financial data
- Call center (remote)
- Excellent problem-solving and decision-making skills
- Ability to work independently and collaboratively in a fast-paced environment
- Exceptional attention to detail and accuracy - Excellent written and verbal communication skills
- Investigated and resolved complex compliance appeals and fraud cases in accordance with regulatory guidelines and internal policies
- Conducted thorough analysis of financial transactions, documents, and customer information to identify potential fraudulent activities
- Collaborated with cross-functional teams including legal, risk management, and law enforcement agencies to ensure timely resolution of cases
- Prepared detailed reports documenting investigation findings and recommended actions to mitigate risk
- Assisted in the development and implementation of fraud prevention strategies and training programs for employees
- Stayed updated on industry trends, new regulations, and emerging fraud schemes to proactively identify potential risks
- Morgantown, WV
Fundraising Specialist
InfoCision
01.2018 - 11.2021
- As a front-line fundraiser, identifying and building relationships with prospective donors, including planning cultivation events, attending conferences and other events that offer opportunities to network in the global philanthropic communities and holding discovery meetings
- Call center (remote)
- Developing marketing and investor materials for potential and existing investors
- Initiating outbound phone calls to clients for membership renewal
- Initiating client relationships and managing entire process, long term relationships
- Developing strategies to encourage new or increased contributions
- Recruit sponsors, participants, and volunteers for fundraising events
- Compiling materials to submit to granting and other funding organizations
- Directing fundraising staff, including volunteer staff members
- Securing commitments of participation from individuals and corporate donors
- Developing and implementing fundraising activities, such as annual giving campaigns
Hiring Manager
J.B. Hunt
01.2018 - 10.2021
- Hire Class A Drivers
- Leadership Skills
- Call center (remote)
- Interview candidates
- Work independently and unsupervised
- Organize employee orientation and schedule training
- Research otr, local and regional positions available in their area
Fundraising Specialist
St. Jude Children's Research Hospital
Memphis, TN
01.2019 - 06.2021
- Company Overview: Memphis, TN
- Cold calling
- Strong leadership qualities
- Creativity and persuasion skills
- Detail oriented
- Call center (remote)
- Memphis, TN
Mover/Packer
Houston Movers
Houston, TX
03.2017 - 06.2021
- Company Overview: Houston, TX
- Responsible for transporting household goods/commercial equipment and furniture from origin to destination
- Inspecting trucks before and after trips, completing and submitting truck condition reports
- Carrying heavy items long distances and up/down stairways
- Providing quality, customer service at all times
- Disassembling and reassembling furniture and equipment
- Loading and unloading trucks
- Houston, TX
Sales Manager
Forever Attire
06.2011 - 05.2020
- Present, promote and sell products/services using solid arguments to existing and prospective customers
- Performing cost-benefit analyses of existing and potential customers
- Maintaining positive business relationships to ensure future sales
- Handling and resolving customer complaints regarding a product or service
Painter
Houston Painters
Houston, TX
05.2012 - 04.2016
- Paint the interior and exterior of buildings and homes, including apartments, townhomes, condos and multi-family dwellings
- Work with contractors and subcontractors to design a timeline regarding when it is best to paint an area or structure to avoid problems while building
- Collaborate with several other painters on large jobs, using all ideas to create the best possible solution for the job
- Protect nearby items or furnishing before and during every job, including outlet covers, landscaping, lighting fixtures, cabinetry and carpets
- Complete smaller projects and touch-ups to ensure that paint matches and blends with the rest of the area
- Meet with clients, building owners and managers to discuss finish and color options as well as any other design details important to the job
- Use safety equipment and ventilators to ensure that everyone on the job is safe at all times
- Practice self-motivation and motivating others, as there may not always be a supervisor on hand to direct you
Youth Counselor
Marion County Parks and Recreation
Fairmont, WV
06.2010 - 08.2010
- Company Overview: Fairmont, WV
- Conducting intake interviews with clients and families
- Educating children about social issues substance and domestic violence
- Providing a reliable presence in the life of children who may feel otherwise abandoned
- Fairmont, WV
Radio Commercial Advertising
102 WVAQ
Fairmont, WV
05.2009 - 06.2009
- Company Overview: Fairmont, WV
- Stir emotions and create demand
- On air personality; sponsorships
- Fairmont, WV
Education
Associate of Applied Science - Business
McLennan Community College
Waco, TX05.2020
High School Diploma -
Fairmont Senior High School
Fairmont, WV05.2010
Skills
- Intake
- Fundraising
- Customer service
- Phone etiquette
- Microsoft Outlook
- Moving Experience
- Customer support
- Organizational know how
- Typing
- Medical Records
- Lead generation
- Organizational skills
- Outbound sales
- Communication skills
- Sales
- Microsoft Powerpoint
- Computer skills
- Problem solving abilities
- Behavioral Health
- B2B sales
- Collaboration talent
- Cold calling
- Microsoft Word
- Leadership experience
- Citrix
- Recruiting
- ICD-10
- People skills
- Microsoft Office
- Individual / group counseling
- Management
- Leadership
- Supervising experience
- Document Review
- Client Representation
- Research proficiency
- Creative and Critical Thinking
- Attention to Detail
- Community Advocacy
- Problem-solving aptitude
- Professionalism
- Relationship Building
- Teamwork and Collaboration
- Adaptability and Flexibility
- Non-Profit Operations
- Time management abilities
- Organizational Skills
- Interpersonal Skills
- Problem-solving abilities
- Professional Communication
- Analytical Skills
Certification
- AED Certification, 11/01/23, 11/01/25, American Heart Association
- CPR Certification, 11/01/23, 11/01/25, American Heart Association
- General Business, 05/01/20, Present, McLennan Community College
Personal Information
Work Permit: Authorized to work in the US for any employer
Assessments
- Inside sales, Proficient, 02/01/22
- Retail customer service, Proficient, 08/01/23
- Technical support: Customer situations, Proficient, 01/01/23
- Sales fit, Proficient, 02/01/22
- Patient-focused care, Proficient, 06/01/24
- Basic computer skills, Proficient, 03/01/22
- Administrative assistant/receptionist, Proficient, 12/01/21
- Proofreading, Proficient, 01/01/22
- Written communication, Proficient, 12/01/21
- Customer service, Proficient, 02/01/22
- Medical receptionist skills, Proficient, 12/01/22
- Data entry: Attention to detail, Proficient, 01/01/22
- Call center customer service, Proficient, 01/01/23
- Analyzing data, Proficient, 12/01/21
- Social media, Proficient, 02/01/22
- Sales skills, Proficient, 01/01/22
Timeline
Medical Claims Specialist
Cigna Healthcare
06.2023 - Current
Provider Relations Specialist
Evernorth Behavioral Health
12.2021 - 12.2023
Stand Leader
Constellation Field
08.2021 - 08.2023
Claims and Billing Specialist
Delta Dental
05.2020 - 06.2023
Fundraising Specialist
Special Olympics
02.2019 - 12.2022
Fundraising Specialist
St. Jude Children's Research Hospital
01.2019 - 06.2021
Fraud Specialist
Bank of America
05.2018 - 11.2022
Fundraising Specialist
InfoCision
01.2018 - 11.2021
Hiring Manager
J.B. Hunt
01.2018 - 10.2021
Mover/Packer
Houston Movers
03.2017 - 06.2021
Painter
Houston Painters
05.2012 - 04.2016
Sales Manager
Forever Attire
06.2011 - 05.2020
Youth Counselor
Marion County Parks and Recreation
06.2010 - 08.2010
Radio Commercial Advertising
102 WVAQ
05.2009 - 06.2009
Associate of Applied Science - Business
McLennan Community College
High School Diploma -
Fairmont Senior High School