Professional with strong background in customer service, adept at handling client inquiries and resolving issues efficiently. Skilled in communication, problem-solving, and conflict resolution, consistently ensuring customer satisfaction. Highly adaptable, team-oriented, and results-driven, excelling in fast-paced, dynamic environments. Passionate about fostering positive customer experiences and contributing to team success.
Hi, I’m
Cassandra Newton
Summary
Overview
5
years of professional experience
Work History
Primis Bank
Customer Service Advocate I
09.2024 - 01.2025
Job overview
- Answering inbound customer calls, written requests, e-service message and chats using authenticated and unauthenticated pin method
- Provide outstanding customer experience by managing customer concerns through touch resolution
- Process request and notify customer approval or denial via telephone, email communication channels
- Perform quality control reporting and tracking to monitor services levels and customer trends
- Assist with online account opening applications by providing information to applicants on status and next steps in the process
- Create and analyze, and provide management performance and statistical report for trending customer data
- Managing over thirty-six system on a daily
- Adhere to state and federal compliance regulations and bank policies and procedures
- Perform other duties as assigned
Atlantic Vision Partners
Medical Insurance Collections
11.2023 - 09.2024
Job overview
- Entering claims diagnosis and treatment codes and modifier and provider information
- Submit insurance claims to clearinghouses and individual insurance companies electronically and via paper CMS-1500 form
- Answering patient questions on patient responsible balances, copays, deductibles, write-offs
- Resolving customer compliant and explaining why certain services are not covered
- Follow up with insurance companies on unpaid or rejected claims resolve issue and re-submit claims
- Follow-up with pass due patient balance provider necessary information to collection agencies for delinquent accounts
- Prepare and submit secondary claims upon processing by primary insurer
- Post insurance and patient payments using medical claiming and billing software
- Verifies patient benefits eligibility and coverage
- Process patients and carrier refunds
- Meeting quality indicators through auditing or recording
Capital Area Health Network
Insurance Verification Specialist
03.2023 - 10.2023
Job overview
- Collect insurance information and verifies it in detail, including co-insurance and deductibles copay and in/out of network benefits
- Review accounts and determine how much a patient needs to pay based on current benefits
- Determine if patient qualifies for sliding scales
- Makes notation I the system of the amount patient is responsible for paying
- Notates the system with the number that is called to verify benefits, along with the representative’s name and amount due
- MS Office, Practice Management Systems,(eClincal/Works), Insurance payer websites
- Medical insurance Terminology, extensive knowledge of CPY, HCPCS and ICD-10 codes
- Checking discrepancies and updating the relevant databases and managing and processing and analyzing insurance claims, detecting coding errors
- Making sure to meet Compliance, Clinic, Medicare, Medicaid guidelines
- Training of other team members
- Processing and research claim denials
Universal Health Services Inc
Reimbursement Specialist Analysis
01.2020 - 02.2023
Job overview
- Responsible for the resolution of accounts entered into the audit and denial and account receivable systems
- Enter and follow up with payer in reference to what is due on the accounts
- Work with payer and facilities to obtain decision letters and any additional information required
- Work with appeal staff for resolution on denied accounts
- Routing appeals relating to technical and clinical issue identified during the billing of claims, denial or receipt of audit
- Work with HIM, vendors and facility clinicians to correct deficiencies in a timely manner
- Working with insurance companies to secure payment on account balances outstanding patient account with action taken to resolve issue
- Meeting productivity standards and department goals and objectives
- Other duties as assigned
Education
Wellesley College Wellesley, MA
BBA from Business Administration
08.1988
University Overview
GPA: 3.5
Skills
- Strong computer skills
- Microsoft Word
- Microsoft Excel
- Communication
- Interpersonal skills
- Public communication
- Manage high volume work load
- Call center experience
- Data entry
- Administrative support
- Data collection
- Microsoft outlook
- Live chat support
- Customer service
- Email management
Timeline
Customer Service Advocate I
Primis Bank
09.2024 - 01.2025
Medical Insurance Collections
Atlantic Vision Partners
11.2023 - 09.2024
Insurance Verification Specialist
Capital Area Health Network
03.2023 - 10.2023
Reimbursement Specialist Analysis
Universal Health Services Inc
01.2020 - 02.2023
Wellesley College
BBA from Business Administration
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