Chelsea Sims
Houston,TX
Summary
Highly organized individual with a track record of successfully handling multiple projects at once. Demonstrates exceptional attention to detail and accuracy in all tasks. Committed to contributing to team success through effective collaboration.
Overview
2
2
years of professional experience
Work History
Patient Sitter
Assisted Living Facility
04.2023 - 2025
- Monitored patient behavior and vital signs to ensure safety and well-being.
- Assisted nursing staff with daily tasks, enhancing workflow efficiency.
- Provided companionship and support to patients, improving their emotional health.
- Maintained a clean and organized environment, promoting patient comfort.
Healthcare Customer Service Representative/Claims Representative
CareCentrix
01.2022 - 01.2023
- Reviewed and processed medical claims for accuracy and completeness, ensuring adherence to billing regulations and insurance policies.
- Investigated and resolved claim denials, rejections, and billing discrepancies, working closely with healthcare providers and insurers to facilitate payment.
- Communicated with patients regarding insurance coverage, billing inquiries, and payment options, providing assistance and support as needed.
- Maintained accurate records of claim status, payments, and follow-up actions, ensuring timely resolution and reimbursement.
Healthcare Customer Service Representative
SupportNinja
01.2021 - 01.2022
- Professionally and empathetically communicate insurance policy details, benefit coverage, eligibility criteria, and claim procedures to policyholders and members.
- Guide individuals through the healthcare insurance enrollment process, helping them understand available options and eligibility requirements.
- Proactively identify opportunities for policyholders to maximize their benefits, including preventive care, wellness programs, and available resources.
- Accurately document and review healthcare claims, ensuring that all required information is captured for processing, and maintain detailed records of claims submissions and outcomes.
Education
Associate of Science -
Houston Community College
Houston, TXSkills
- Insurance Verification
- Medical terminology knowledge
- Customer Service
- Payment Processing
- Data entry
- De-Escalation Techniques
- Email Support
- Chat Support
- Claims
- Benefits Explanations
- Exceeding Customer Expectations
- Pre-Authorization Assistance
- Eligibility Determination
- Problem-Solving
- Time Management
- Basic medical terminology
- Stress tolerance
- Feeding assistance
- Patient communication
- Light housekeeping
- Compassionate care
- Record keeping proficiency
- Maintaining patient privacy
- Patient monitoring
- Nursing support
- Patient care
Timeline
Patient Sitter
Assisted Living Facility
04.2023 - 2025
Healthcare Customer Service Representative/Claims Representative
CareCentrix
01.2022 - 01.2023
Healthcare Customer Service Representative
SupportNinja
01.2021 - 01.2022
Associate of Science -
Houston Community College
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