Christin King
Philadelphia,PA
Summary
Presents themselves with strong leadership capabilities, highly trained in
customer service. I am knowledgeable with several computer systems
and medical terminology. Flexible and diligent employee, able to meet all
required deadlines and perform all job task effectively and efficiently.
Energetic and enthusiastic insurance professional motivated to succeed in fast-paced and deadline-driven professional environment. Comprehensive knowledge of claims adjustments with special knowledge of auto appraisals and CCC pathways estimations.
Overview
16
16
years of professional experience
Work History
Provider Claim Resolution Specialist
AmeriHealth Caritas
Philadelphia, PA, PA
08.2023 - Current
- Investigated potential fraud cases by analyzing documentation submitted by providers.
- Communicated with internal departments on behalf of providers to resolve billing problems.
- Identified trends in denied claims and recommended process improvements.
- Reprocess Claims
- Provide Eligibility for benefits
- Update providers on appeal status
- Developed strategies to maximize revenue collections from insurance companies.
- Participated in training sessions related to coding changes, billing system updates.
- Responded promptly to inquiries from providers regarding their accounts receivable status.
- Worked closely with providers to resolve pending claim issues and disputes.
Customer Service Representative
Philadelphia Gas and Electric Heating and Air Conditioning
Philadelphia, PA
09.2014 - 02.2024
- Take member calls and provide accurate,
satisfactory responses to their inquires - Manage calls involving dissatisfied customers,
offering assistance and support, escalating items
for quick resolution - Collaborate with internal departments and vendors
to facilitate resolutions to members inquires - Document details on every call in the required
systems for future follow up, data collection and
reporting - Operated multi-line phone system to receive emergency calls.
- Coordinated with first responders to dispatch appropriate units promptly.
- Maintained detailed logs of calls and responses for record-keeping compliance.
- Utilized mapping software to identify locations and routes for responders.
- Trained new team members on processes and company policies.
Customer Service Trainee
Cancer Treatment Centers Of America
Philadelphia, PA
02.2018 - 03.2020
- Manage a team of customer service reps on a daily basis
- Participate in a rotational training program covering all aspects of customer service
- Set goals and provide mentoring /coaching
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service
- Perform quality monitoring on team members and provide feedback
- Audit department processes and identify areas for improvement
- Assist in the recruiting process to fill customer service positions
Member Relations Specialist
Independence Blue Cross
Philadelphia, PA
09.2016 - 02.2018
- Manage customer calls effectively and efficiently in
a complex, fast paced and challenging call center environment - Accurately document, research, and resolve
customer issues - Educate members in a professional manner in
regard to Medicare; eligibility enrolment, billing
claims research ICD-9 and CPT coding - Perform technical support and troubleshooting for
members
Dietary Associate (Part-Time)
Nazareth Hospital, Mercy Health System
Philadelphia, PA
04.2009 - 12.2014
- Perform defined work routines, using various dietary utensils
- supplies and equipment as assigned by the Dietary Manager
Provide assistance to the cook in the preparation and service of meals - Meet scheduled meal and snack times
- Follow Federal and State long term care regulations and Dietary Department policies and procedures
- Preparing cleaning schedules and perform cleaning duties as scheduled
- Assist in arranging tray cards, loading food carts, and serving meals
Education
High School Diploma -
Little Flower Catholic High School
Philadelphia, PA06.2011
Skills
- Customer Service
- Microsoft Office
- Telephone and Email Skills
- Data Entry
- Insurance Practices
- Claims Processing
- Provider Relations
- Billing dispute resolution
- Medical billing proficiency
Education and Training
other
Timeline
Provider Claim Resolution Specialist
AmeriHealth Caritas
08.2023 - Current
Customer Service Trainee
Cancer Treatment Centers Of America
02.2018 - 03.2020
Member Relations Specialist
Independence Blue Cross
09.2016 - 02.2018
Customer Service Representative
Philadelphia Gas and Electric Heating and Air Conditioning
09.2014 - 02.2024
Dietary Associate (Part-Time)
Nazareth Hospital, Mercy Health System
04.2009 - 12.2014
High School Diploma -
Little Flower Catholic High School