Summary
Overview
Work History
Education
Skills
Timeline
Generic

Charmaine Chaney

Barrackville

Summary

Dedicated Remote Administrative and Customer Support Specialist with over 10 years of experience in healthcare and customer service. Proven skills in handling high volumes of inbound communications, with a track record of reducing average call times by 15% and resolving over 100 daily inquiries. Strong background in claims management and member support through remote channels, consistently enhancing operational efficiency. Eager to leverage exceptional customer service and administrative skills to meet the needs of prospective employers.

Overview

14
14
years of professional experience

Work History

Customer Service Representative

Alorica
10.2023 - Current
  • Provided high-volume inbound support remotely, effectively managing over 60 daily calls via Five9 ADT for Anthem Blue Cross Blue Shield Commercial/Medicaid members.
  • Demonstrated expertise in pharmacy benefits, including prior authorizations, achieving a 15% reduction in average call time.
  • Maintained accurate records and updated member demographics utilizing People Safe and Compass.
  • Collaborated with healthcare providers and pharmacists to enhance service delivery.

Medical Claims Reimbursement Specialist

UnitedHealth Group
10.2021 - 10.2023
  • Scrutinized complex healthcare claims remotely for RHRP and VBA contracts, ensuring accurate processing.
  • Managed a high volume of customer inquiries through telephone, written communication, web portals, and fax.
  • Utilized the QNXT system for effective claims management.
  • Reviewed and adjudicated medical claims and non-medical appeals with precision.
  • Identified and rectified incorrectly processed claims, enhancing operational efficiency.

Appointment Scheduler/VA Medical Claims Reimbursement Specialist

The Judge Group
08.2020 - 10.2021
  • Processed claims remotely, managed enrollment, and provided exceptional customer service for Veterans Affairs.
  • Delivered high-volume customer support, successfully resolving over 100 daily inquiries.
  • Efficiently coordinated and registered patients for COVID-19 testing and vaccinations.

Satellite Office Supervisor

United States Medical Supplies
05.2019 - 08.2020
  • Oversaw all operational aspects of the Atlanta satellite office, ensuring effective workflow and service delivery.
  • Applied in-depth knowledge of medical terminology, coding, and billing procedures.
  • Liaised with physicians and government payers to facilitate seamless operations.

Medicaid Member Support Specialist (Contract)

DXC Technology (Radiant Systems Inc.)
01.2019 - 04.2019
  • Handled over 100 daily inbound calls within a Medicaid Member Contact Center, providing thorough assistance to members.
  • Resolved member inquiries related to 1095-B forms and medical benefits, elevating member satisfaction.

Healthcare Customer Service Representative

Teleperformance Call Center
09.2011 - 11.2018
  • Managed 75-125 daily inbound calls, delivering information on AARP and United Health Care plans efficiently.
  • Processed payments and resolved claim rejections and denials, ensuring maximum customer satisfaction.

Education

High School Diploma - High School Diploma or Equivalent

North Marion High School

Skills

  • Healthcare Claims Processing
  • Pharmacy Benefits
  • Data Management & Compliance
  • Credentialing & Compliance
  • Office Management
  • Technical Proficiency
  • Customer Service & Support
  • Communication & Collaboration
  • Problem Solving & Resolution
  • Process Improvement
  • ICD-9 Coding
  • Medical Terminology
  • Medical Records Management
  • Typing Ability
  • Knowledge of Laws

Timeline

Customer Service Representative

Alorica
10.2023 - Current

Medical Claims Reimbursement Specialist

UnitedHealth Group
10.2021 - 10.2023

Appointment Scheduler/VA Medical Claims Reimbursement Specialist

The Judge Group
08.2020 - 10.2021

Satellite Office Supervisor

United States Medical Supplies
05.2019 - 08.2020

Medicaid Member Support Specialist (Contract)

DXC Technology (Radiant Systems Inc.)
01.2019 - 04.2019

Healthcare Customer Service Representative

Teleperformance Call Center
09.2011 - 11.2018

High School Diploma - High School Diploma or Equivalent

North Marion High School

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