CAROLYN MARTIN
DETROIT,MI
Summary
Experienced Customer Service Representative with a proven track record in diverse industries including Medicaid, Unemployment, and HSA/FSA/MRA. Skilled in claim processing and related tasks. Strong work ethic, effective listening skills, and proficiency in customer service and computer applications. Impressive typing speed and outstanding data entry capabilities. Recognized for consistently improving QA scores and maintaining professionalism while demonstrating problem-solving abilities and empathy in customer interactions.
Overview
7
7
years of professional experience
Work History
Claims Processing Specialist
Inspira Financial
Remote
05.2024 - 04.2025
- Review and Process Claims: Accurately analyze and process claims submitted for eligible expenses.
- Verify Information: Obtain and verify claim information to ensure accuracy and completeness.
- Follow Procedures: Adhere to established claims processing policies and procedures.
- Customer Service: Communicate with members about the status of their claims and address inquiries.
- Data Entry: Enter claim data into systems and maintain accurate records.
- Payment Processing: Process payments for eligible claims.
MEDICAID SPECIALIST - CSR
Conduent
11.2023 - 06.2024
- Resolved user inquiries, boosting satisfaction and efficiency.
- Enhanced first call resolution rates, improving service quality.
- Reduced call handling times, maintaining high assistance standards.
- Efficiently resolved issues, enhancing member satisfaction and service quality.
- Verified Medicaid members with precision, ensuring data integrity.
- Informed members about status updates, fostering transparency and trust.
- Entered and confirmed data in Medicaid systems, improving accuracy.
- Utilized problem-solving skills to address member inquiries effectively.
TEAM LEAD - CLAIMS CSR
Direct Interactions
11.2022 - 09.2023
- Led a team of claims representatives, enhancing process efficiency and improving client satisfaction.
- Resolved complex claims issues, achieving measurable improvements in resolution time.
- Trained and mentored new team members, fostering a collaborative and supportive work environment.
- Analyzed claims data to identify trends, implementing strategies that reduced processing errors.
- Coordinated with cross-functional teams to streamline operations, resulting in significant cost savings.
CLAIMS SPECIALIST
Direct Interactions
04.2022 - 11.2022
- Process unemployment claims efficiently, minimizing errors, enhancing claimant satisfaction.
- Guide claimants through appeals and account setup, improving accessibility and user experience.
- Maintain professionalism in interactions, fostering a positive claimant experience.
PATIENT ATTENDANT
Touchpoint - St. John Hospital
Detroit, MI, United States
11.2017 - 04.2022
- Monitored patients bedside and via video, ensuring safety and well-being.
- Transported patients efficiently throughout the hospital, enhancing operational flow.
- Recorded and maintained patient data accurately, supporting effective care delivery.
- Provided compassionate care to patients, ensuring comfort and safety.
- Collaborated with healthcare team to deliver personalized support and enhance patient experience.
Education
CENTRAL STERILE PROCESSING TECHNICIAN -
Michigan Healthcare Academy
MI12.2024
General Studies
Wayne County Community College District
Detroit05.2017
Skills
- Data Analysis
- Time Management
- Problem Solving
- Data Entry
- Technical Support
- Quality Assurance
- Communication Skills
- Empathy Training
- Multitasking
- Customer Retention
- Listening (Expert)
- Leadership Skills (Expert)
- Compassion (Expert)
- Analytical Skills (Expert)
- Problem Solving Skills (Expert)
- Adaptive (Expert)
- Verbal and Written communication (Expert)
- Typing (Expert)
- Flexible (Expert)
Timeline
Claims Processing Specialist
Inspira Financial
05.2024 - 04.2025
MEDICAID SPECIALIST - CSR
Conduent
11.2023 - 06.2024
TEAM LEAD - CLAIMS CSR
Direct Interactions
11.2022 - 09.2023
CLAIMS SPECIALIST
Direct Interactions
04.2022 - 11.2022
PATIENT ATTENDANT
Touchpoint - St. John Hospital
11.2017 - 04.2022
CENTRAL STERILE PROCESSING TECHNICIAN -
Michigan Healthcare Academy
General Studies
Wayne County Community College District