Candace Nelson
Fairfield,CA
Summary
Focused Verification Representative promoting expertise in successfully working for fast-paced organizations. Courteous and cordial with a desire to take on challenges at a new company.
Overview
6
6
years of professional experience
Work History
Verifications Representative
Park Crossing Apartments
Fairfield
03.2019 - 10.2024
- Signed payment approvals accepted claims.
- Collaborated with fellow team members to manage large volume of claims.
- Responded to customer inquiries regarding account status, payment histories, and other related topics.
- Generated regular reports summarizing overall performance of the verification team.
- Communicated with insurance carrier, patient and third party or employer to verify patient insurance benefits.
- Corresponded with insured or agent to obtain information or inform of account status or changes.
- Assisted in the development of new processes for verifying customer information more quickly and accurately.
- Monitored verification queues daily to ensure that all requests were completed within established timelines.
- Processed incoming documents from customers and verified their accuracy prior to entering them into the system.
- Ensured compliance with federal and state regulations regarding insurance verification.
- Navigated through multiple online systems to obtain documentation.
- Ensured compliance with applicable laws, regulations, and internal policies when conducting verifications.
- Collected payments, processed receipts and informed policyholders of outstanding balances.
- Implemented process improvements to enhance efficiency and accuracy of insurance verification.
- Transcribed data to worksheets and entered data into computer to prepare documents and adjust accounts.
- Collaborated with cross-functional teams such as IT, Legal, Compliance, Sales to resolve complex verification issues.
- Performed additional duties as assigned by management related to verification activities.
Education
Master of Science - Information Technology
American Military University
Charleston, WV01-2025
Bachelor of Science - Healthcare Administration
American Military University
Charleston, WV01-2022
Skills
- Benefits verification
- Background checks
- Issue researching
- Secure data practices
- Statement preparation
- Prior authorization processing
- Data entry and review
- Customer database systems
- Database management
- Customer service
- Communication and interpersonal skills
- Proficient in CRM
- Data integrity
- Fraud detection
- Policy interpretation
References
References available upon request.
Timeline
Verifications Representative
Park Crossing Apartments
03.2019 - 10.2024
Master of Science - Information Technology
American Military University
Bachelor of Science - Healthcare Administration
American Military University
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