Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Caya Jefferies

Ocoee,FL

Summary

Dynamic healthcare professional with expertise in health insurance and customer service, honed at Sunrise Health Care. Excelled in resolving complex billing issues and enhancing client satisfaction. Proven ability to analyze client needs and maintain HIPAA compliance. Achieved a 95% customer satisfaction rate through effective communication and proactive problem-solving.

Overview

6
6
years of professional experience

Work History

Healthcare Insurance Representative

Sunrise Health Care
Charlotte, NC
04.2023 - 04.2026
  • Assisted members with questions regarding healthcare coverage, eligibility, claims, and benefits
  • Verified insurance information and updated member accounts accurately
  • Processed prior authorization requests and communicated updates to providers and patients
  • Resolved billing and claim issues while maintaining high customer satisfaction
  • Documented customer interactions and account updates in company systems
  • Worked closely with healthcare providers and internal departments to ensure timely claim resolution
  • Maintained HIPAA compliance and protected confidential patient information

Patient Support Specialist

Carolina Medical Network
Charlotte, NC
02.2020 - 04.2023
  • Scheduled patient appointments and verified insurance coverage
  • Assisted patients with referrals, co-pay questions, and insurance documentation
  • Entered patient demographics and insurance information into electronic systems
  • Handled high-volume inbound calls while providing professional customer service
  • Helped patients understand healthcare benefits and payment responsibilities

Education

High School Diploma -

White Oak High School
Jacksonville, NC
06.2018

Skills

Quotes and sales

Customer follow-up

Client needs analysis

Goal-oriented mindset

Health insurance

Customer service

Accomplishments

Throughout my healthcare insurance experience, one of my biggest accomplishments was consistently helping members resolve complex billing and claims issues while maintaining strong customer satisfaction. I became known for being dependable, patient, and detail-oriented when handling sensitive insurance information and assisting patients with understanding their benefits. I also improved my ability to manage high call volumes, multitask efficiently, and work closely with providers and team members to ensure claims and authorizations were processed accurately and on time.

Timeline

Healthcare Insurance Representative

Sunrise Health Care
04.2023 - 04.2026

Patient Support Specialist

Carolina Medical Network
02.2020 - 04.2023

High School Diploma -

White Oak High School
Caya Jefferies