Summary
Overview
Work History
Education
Skills
Timeline
Generic

Candice Campbell

Tampa ,FL

Summary

Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

22
22
years of professional experience

Work History

Senior Claim Customer Service

Centene
03.2022 - Current
  • Resolved customer service issues using company processes and policies and provided updates to customers.
  • Escalated issues to proper supervisors when standard processes were not effective.
  • Researched and rapidly resolved client conflicts to maintain key accounts.
  • Handled customer inquiries and complaints with professionalism to restore satisfaction.
  • Utilized active listening skills to understand customer needs and provide tailored solutions.
  • Trained and directed new employees in call script use, conflict resolution, and data entry practices to boost customer satisfaction ratings.

Claims Representative

Apria Healthcare
10.2015 - 02.2020
  • Analyzed and addressed escalated claims to resolve issues quickly.
  • Worked productively in fast-moving work environment to process large volumes of claims.
  • Researched and analyzed complex claims to determine next steps and possible outcomes.
  • Updated claims system to track claim status and provide relevant information to other department.
  • Examined reports, accounts, and evidence to determine integrity and accuracy of information.
  • Prepared insurance claim forms or related documents and reviewed for completeness.

Claims Associate

HealthPlan Services
10.2014 - 10.2015
  • Maintained confidentiality of patient finances, records, and health statuses.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Verified client information by analyzing existing evidence on file.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
  • Processed and recorded new policies and claims.
  • Determined appropriateness of payers to protect organization and minimize risk.

Intake Coordinator

WellCare Health Plans Inc.
06.2008 - 02.2011
  • Completed intake assessment forms and filed clients' charts.
  • Answered phone calls and provided new clients with required paperwork to initiate service.
  • Collected, verified, recorded and processed client demographics, insurance payments, and referral information.
  • Communicated with referral sources, physicians, and associated staff to check documentation for proper signatures.
  • Entered referrals into appropriate system based on type of referral obtained.

Customer Service Representative

Medco Health Solutions
03.2001 - 05.2008
  • Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
  • Answered customer telephone calls promptly to avoid on-hold wait times.
  • Answered constant flow of customer calls with minimal wait times.
  • Offered advice and assistance to customers, paying attention to special needs or wants.

Education

High School Diploma -

Howard W. Blake High School
Tampa, FL
05.2001

Skills

  • Conflict Resolution
  • Issue Research
  • Good Communication Skills
  • Complaint Resolution
  • Inbound and Outbound Calling
  • Answering Client Questions
  • Understanding Customer Needs
  • Status Updates
  • Resolving Complex Issues
  • Answering Phones
  • Verifying Eligibility
  • Information Updates

Timeline

Senior Claim Customer Service

Centene
03.2022 - Current

Claims Representative

Apria Healthcare
10.2015 - 02.2020

Claims Associate

HealthPlan Services
10.2014 - 10.2015

Intake Coordinator

WellCare Health Plans Inc.
06.2008 - 02.2011

Customer Service Representative

Medco Health Solutions
03.2001 - 05.2008

High School Diploma -

Howard W. Blake High School

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Candice Campbell