Cailinn Latham
Birmingham,AL
Summary
Customer Service Representative with background in providing exceptional support and resolving customer inquiries. Skilled in communication, problem-solving, and maintaining positive relationships with customers. Demonstrated ability to improve customer satisfaction and loyalty through attentive service and effective issue resolution. Committed to enhancing team performance by sharing knowledge and best practices in customer service operations.
Overview
7
7
years of professional experience
Work History
Patient Financial Counselor
Alabama Oncology
Birmingham, AL
10.2024 - 03.2025
- Verified patients' insurance and payment methods during admissions or check-in processes.
- Provided clear explanations of billing policies and procedures to both internal and external customers.
- Counseled patients on financial obligations associated with their medical care.
- Coordinated the transfer of unpaid patient balances between departments within the hospital system.
- Initiated application processes to add patients to assistance programs at bedside and followed through until completion.
- Screened patients for eligibility for state, local and federal assistance programs.
- Assisted patients in understanding the details of their bills, including deductibles and co-pays.
- Researched discrepancies between charges and payments received from insurance companies or other sources.
- Counselled patients on potential financial liabilities and payment requirements.
Customer Service Specialist
Blue Cross Blue Shield of Alabama
Birmingham, Alabama
01.2021 - 10.2024
- Answered inbound calls, chats and emails from providers
- Verified benefits and eligibility for members to providers
- Checked for and submitted authorization requirements
- Explained and checked billing and claim statuses
- Updated claims and process corrected claims
- Provided outstanding service to new and long-standing customers by attending closely to concerns and developing solutions.
- Adjusted bills and refunded money to resolve customers' service or billing complaints.
Prior Authorization Specialist
Evicore Healthcare
Birmingham, Alabama
06.2018 - 01.2021
- Verified patient insurance coverage, including eligibility, benefits and authorizations for medical services.
- Analyzed trends in authorization denials and reported findings to management for quality improvement initiatives.
- Collaborated with insurance companies to clarify coverage details and resolve issues related to prior authorization.
- Followed up on pending prior authorization requests to ensure timely processing.
- Determined which party would be liable for payment on medical services by thoroughly reviewing patient insurance coverage.
- Trained new staff on prior authorization procedures and company policies.
- Contacted insurance companies to obtain necessary preauthorizations needed for upcoming tests and procedures.
- Maintained files for referral and insurance information, entering referrals into system.
Education
High School Diploma -
Clay Chalkville High School
Pinson, AL05-2016
Skills
- Customer service
- Claims processing
- Benefit verification
- Prior authorization
- Data entry
- Insurance communication
- Problem solving
- Attention to detail
- Time management
- Training and mentoring
- Account management
- Telephone etiquette
- Customer relations
- Good communication skills
- Excellent written and oral communication
- Customer retention
- Problem resolution
- CRM software
- Call centers
- Call center experience
- Customer relationship management (CRM)
- Medical terminology
- 10-key
- Multi-task management
- Multi-line telephone operations
- Computer proficiency
- Appointment scheduling
- Administrative support
- Microsoft Excel
Timeline
Patient Financial Counselor
Alabama Oncology
10.2024 - 03.2025
Customer Service Specialist
Blue Cross Blue Shield of Alabama
01.2021 - 10.2024
Prior Authorization Specialist
Evicore Healthcare
06.2018 - 01.2021
High School Diploma -
Clay Chalkville High School