High-performing individual that will deliver an enhanced customer service experience while supporting members as their front-door to Mental Health Wellbeing.
Overview
7
7
years of professional experience
Work History
Senior Claims Analyst
First Financial Asset Management
Atlanta, GA
04.2021 - 10.2023
Investigate and coordinate insurance benefits for insurance claims across multiple service lines
Obtain claim status via the telephone, internet, and/or fax
Review and understand eligibility of benefits
Resolve accounts as quickly and accurately as possible, obtaining maximum reimbursement, and perform investigative and follow up activities in a fast-paced environment
Conduct research, contact patients, and the local affiliates to include VA, Hospitals, and insurance carriers
Handle incoming and outgoing mail, scanning, and indexing documents and handling any other tasks that are assigned
Research and verify insurance billing adjustment identification to ensure proper account resolution and act when necessary
Identify contractual and administrative adjustments
Work independently or as a member of a team to accomplish goals
Demonstrate excellent customer service, communication skills, creativity, patience, and flexibility
Follow established organization guidelines to perform job functions while staying abreast to changes in policies
Correspond with hospital contacts professionally using appropriate language while following the specific facility and department protocol
Uphold confidentiality regarding protected health information and adhere to HIPPA regulation
Interact with all levels of staff
Cross train in multiple areas and perform all other duties as assigned by management.
Claims Analyst
Aspirion Health Resources
Columbus, GA
10.2019 - 03.2021
Investigate and coordinate insurance benefits for insurance claims across multiple service lines
Obtain claim status via the telephone, internet, and/or fax
Review and understand eligibility of benefits
Resolve accounts as quickly and accurately as possible, obtaining maximum reimbursement, and perform investigative and follow up activities in a fast-paced environment
Conduct research, contact patients, and the local affiliates to include VA, Hospitals, and insurance carriers
Handle incoming and outgoing mail, scanning, and indexing documents and handling any other tasks that are assigned
Research and verify insurance billing adjustment identification to ensure proper account resolution and act when necessary
Identify contractual and administrative adjustments
Work independently or as a member of a team to accomplish goals
Demonstrate excellent customer service, communication skills, creativity, patience, and flexibility
Follow established organization guidelines to perform job functions while staying abreast to changes in policies
Correspond with hospital contacts professionally using appropriate language while following the specific facility and department protocol
Uphold confidentiality regarding protected health information and adhere to HIPPA regulation
Interact with all levels of staff
Cross train in multiple areas and perform all other duties as assigned by management.
Customer Support Chat Associate
Asurion
05.2019 - 10.2019
Providing a value-added experience with outstanding customer service to customers while resolving issues related to their device
Give logical troubleshooting steps to resolve operation issues
Uses knowledge-based systems and other tools to deliver technical support solutions
Support the chat automation process to ensure the members are led to a successful service to fulfill the inquires presented.
Healthcare Customer Service Representative
CVS
01.2019 - 01.2019
Facilitated process for requesting prior authorizations for commercial and Medicare D medication claims
Assisted operations with electronically adjudicated claims to ensure medication is reconciled and paid for prior to delivery
Followed up on all unpaid claims and aging A/R items
Participated in third-party and/or Medicare claim audits to minimize financial exposure.
Responsible for monitoring and responding to inbound messages and outbound calls to support our provider services.
Chat Support Specialist
GC Services
01.2018 - 01.2019
Answered customers' questions via chat about Apple products
Walked customers through troubleshooting regarding accessories including software and hardware.
Work Seamlessly with AI chatbot to deliver a combination of human interaction and AI transaction
Tier 2 Advisor-Team Leader
Concentrix
01.2017 - 01.2018
Managed call flow and responded to technical support needs of customers
Demonstrated professionalism, empathy, and courtesy with customers at all times
Researched and analyzed information across multiple tools to answer customer questions.