Cheyenne Stephenson
Insurance
Lubbock,TX
Summary
Results-driven professional poised for success in the next role, with a proven track record of navigating complex claims processes and delivering impactful decisions. Highly collaborative team player dedicated to achieving optimal outcomes, leveraging strong interpersonal skills to foster effective communication and cooperation. Known for reliability and adaptability, consistently responding to changing needs while maintaining a focus on excellence. Committed to driving results and enhancing organizational effectiveness through strategic problem-solving and innovative thinking.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Disability Claims Specialist
Southwest Service Administrators Inc.
07.2023 - Current
- Provided exceptional service to clients through prompt response times, clear explanations of policy terms, and compassionate support throughout the claims process.
- Collaborated with healthcare providers to obtain crucial information, leading to more accurate and faster decision-making on claims.
- Demonstrated attention to detail when reviewing medical records, enabling accurate assessment of functional limitations caused by disabilities.
- Managed high caseloads effectively, ensuring all disability claims were processed promptly and accurately.
- Enhanced customer satisfaction with timely communication and empathetic support during the claims process.
- Mentored junior team members in handling complex cases, resulting in better decision-making and improved overall team performance.
Insurance Agent
Self-employeed
05.2016 - Current
- Built strong relationships with clients through consistent communication and excellent customer service.
- Responded to customer calls swiftly to resolve issues and answer questions.
- Efficiently managed policy renewals, ensuring timely processing and accurate coverage updates.
- Maintained high standards of customer service by building relationships with clients.
- Educated clients on the importance of adequate insurance coverage, fostering trust and loyalty among the existing client base.
- Increased client satisfaction by providing personalized insurance solutions tailored to individual needs.
- Expanded client base by actively prospecting for new business opportunities and generating referrals.
- Provided prompt responses to inquiries from both prospective and existing clients, demonstrating a commitment to exceptional service.
- Developed comprehensive knowledge of various insurance products, enabling effective recommendations for clients'' unique situations.
Medical Claims Analyst
Friday Health plans
08.2021 - 08.2023
- Analyze incoming medical claims using ICD-9, CPT, HCPCS coding, and Medicare fee schedules.
- Determine if claims are in compliance under patient benefit plans for payments using DRG regulations :
- Review medical records to determine if the ICD-9, CPT codes and modifiers are processed correctly.
- Adhere to the HIPAA privacy, security regulations, and maintain confidentiality of patient a business records.
- Research medical claims issues in response to informational inquiries by accessing and interpreting EOB's and claims history.
- Follow all applicable Medi-Cal and Medicare government regulations including HIPPA.
- Receive Medicaid claims from medical and specialty providers to determine reimbursement.
- Bill insurance companies electronically and resolve EOB issues regarding insurance payment.
- Audit data handling during transitional process, report issues legal department and HIPPA compliance officer to ensure confidentiality and regulatory compliance
- Enter and perform adjudication process for HSA and FSA claims for various company's employees to receive payment's.
- Adjudicate incoming claims in accordance with policy, procedures guide lines.
- Assist in the processing of medical, dental and vision claims from multiple lines of business
Insurance Agent
American National Insurance
05.2016 - 06.2020
- Provides service to clients' changing insurance needs by selling life, health, and disability insurance.
- Establishes productive working relationships with clients.
- Develops base for long-term sources of clients.
- Compiles lists of prospects.
- Determines clients' particular needs and financial situations by scheduling fact-finding appointments and determining the extent of present coverage and investments.
- Ascertains clients' long-term goals.
- Develops a coordinated protection plan by calculating and quoting rates for immediate coverage action and long-term strategy implementation.
- Communicates with adjusters.
- Obtains underwriting approval by completing application for coverage.
- Completes coverage by delivering policy, planning future follow-up visits, and evaluations of needs.
- Provides continuing service by providing direct deposit forms, processing changes in beneficiary, and analyzing policy loan applications.
- Provides death benefits by delivering policy proceeds and reassessing client needs.
- Updates job knowledge by participating in educational opportunities, maintaining personal networks, and participating in professional organizations.
- Enhances insurance agency reputation by accepting ownership for accomplishing new and different requests and exploring opportunities to add value to job accomplishments.
Education
Associate in Science (A.S.) - Nursing
Trinidad State Junior College
Alamosa, CO05.2021
High School Diploma - undefined
Sargent High School
Monte Vista, CO05.2008
Skills
- Detailed oriented
- Dependable
- Organized
- Honest
Certification
- State of Colorado 508952
- State of New Mexico17959480
- State of Texas 2757747
Extracurricular Activities
Basketball Team 4-H FFA
Timeline
Disability Claims Specialist
Southwest Service Administrators Inc.
07.2023 - Current
Medical Claims Analyst
Friday Health plans
08.2021 - 08.2023
Insurance Agent
Self-employeed
05.2016 - Current
Insurance Agent
American National Insurance
05.2016 - 06.2020
High School Diploma - undefined
Sargent High School
Associate in Science (A.S.) - Nursing
Trinidad State Junior College
Awards
National Junior Honor Society, FBLA
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