Cameron Milton
Clearwater,FL
Summary
Dedicated and knowledgeable Benefits Representative with over 5 years of experience in customer service and benefits administration. Proficient in guiding employees through benefits packages, enrollment procedures, and resolving benefits-related inquiries. Demonstrates strong communication skills, empathy, and a commitment to delivering exceptional service in a remote environment.
Overview
9
9
years of professional experience
Work History
Patient Care Representative
CCS Medical DME
03.2019 - 10.2024
- Served as the primary point of contact for patients, providing detailed information on health insurance coverage, eligibility, and enrollment procedures.
- Assisted patients in navigating the benefits enrollment process, ensuring they understood plan options and coverage details.
- Investigated and resolved patient inquiries related to benefits discrepancies, claim denials, and billing errors by collaborating with internal departments and external vendors.
- Maintained accurate records of all patient interactions, ensuring compliance with privacy regulations and confidentiality policies.
- Conducted patient education sessions to inform individuals about new benefits offerings and policy changes.
- Maintain accurate patient records in compliance with HIPAA and company policies.
Healthcare Customer Service Representative
Marshfield Clinic
remote, FL
05.2017 - 03.2019
- Provided comprehensive support to customers regarding their health benefits, including answering questions about coverage options and enrollment procedures.
- Resolved customer inquiries related to benefits discrepancies, claim denials, and billing issues by coordinating with internal teams and external partners.
- Assisted customers with navigating online enrollment portals and addressed technical issues to facilitate a smooth enrollment experience.
- Maintained detailed records of customer interactions, ensuring adherence to confidentiality policies and privacy regulations.
- Skilled in handling high-volume inbound and outbound calls, resolving complex inquiries, and providing patient education with empathy and accuracy. Strong knowledge of medical benefits, insurance eligibility, prescriptions, and reimbursement processes. Proficient with Microsoft Office, Windows-based systems, and multi-tasking across multiple applications in fast-paced environments.
- Provided customer service for patients with insurance, prescription, and benefits-related inquiries.
- Handled complex billing and coverage concerns, resolving issues through collaboration with insurers and internal teams.
- Delivered patient education on prescription coverage and reimbursement requirements.
Claims Representative
Carenet
remote, FL
01.2016 - 05.2017
- Processed claims by reviewing documentation and verifying policy details.
- Communicated with clients to gather necessary information for claim evaluations.
- Coordinated with medical providers to obtain records supporting claim decisions.
- Processed a high volume of claims efficiently while maintaining quality standards.
- Skilled in researching and resolving claim denials, verifying eligibility, and collaborating with payers to ensure timely reimbursement. Strong knowledge of insurance protocols, HIPAA compliance, and medical terminology (ICD, CPT, HCPCS).
- Verified patient insurance eligibility and provided accurate coverage information prior to scheduling services.
- Assisted patients with pre-authorization, enrollment paperwork, and claim-related questions.
- Maintained detailed scheduling and insurance records in compliance with HIPAA regulations.
- Resolved scheduling and benefits-related issues, improving efficiency and patient satisfaction.
- Researched and resolved denied and rejected claims by reviewing payer edits, submitting appeals, and preparing supporting documentation.
- Verified insurance eligibility and benefits using payer databases and internal systems.
- Processed claims adjustments and reconciled payment variances to ensure timely reimbursement.
- Collaborated with providers, physicians, and patients to collect necessary documentation supporting claim payments.
- Reviewed EOBs/EOPs for accuracy of patient responsibility and initiated corrections as needed.
Education
GED -
PTEC
St Peterburg11-2015
Skills
- Medical Claims Processing & Appeals
- Denial Research & Resolution
- Eligibility & Benefits Verification
- Insurance & Government Payers Protocols
- Accounts Receivable Adjustments
- EOB/EOP Accuracy Review
- CPT, HCPCS, ICD Coding Knowledge
- HIPAA, Fair Credit & Collections Act Compliance
- Microsoft Office (Excel, Access, Word)
- Provider & Patient Communication
- Documentation & Reporting
Timeline
Patient Care Representative
CCS Medical DME
03.2019 - 10.2024
Healthcare Customer Service Representative
Marshfield Clinic
05.2017 - 03.2019
Claims Representative
Carenet
01.2016 - 05.2017
GED -
PTEC
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