CIARA Atanda
Summary
Customer Service Professional experienced in managing high volumes of inbound calls and maintaining customer satisfaction. Delivered effective resolutions to escalated support issues through strong active listening and multitasking abilities. Contributed to team success by prioritizing tasks in fast-paced environments and supporting senior team members with complex claims processing.
Overview
4
4
years of professional experience
Work History
Insurance Claims Specialist
Humana
Florida
01.2021 - 01.2024
- Reviewed medical records for accuracy of information required for pre-authorization requests, enhancing approval rates.
- Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers.
- Maintained accurate documentation on all pre-authorization requests, denials and appeals.
- Identified discrepancies in patient's insurance coverage or benefits, ensuring accuracy of data entered into system.
- Resolved claim issues related to billing and reimbursement inquiries, facilitating timely payments.
- Analyzed complex health plan contracts to determine benefit coverage levels for services rendered.
- Performed daily audits of submitted claims to ensure compliance with industry standards and regulations.
Customer Service Representative
Just energy
Dacada
04.2020 - 12.2023
- Answered customer inquiries, delivering accurate information on products and services to enhance customer satisfaction.
- Assisted customers with product selection, ordering, billing, returns, exchanges and technical support.
- Collected customer feedback through surveys, utilizing insights to refine customer service processes.
- Guided customers through product selection, ordering, billing, returns, exchanges, and technical support to ensure a seamless experience.
- Maintained detailed records of customer interactions, transactions and comments for future reference.
- Performed administrative tasks such as filing paperwork, updating databases and generating reports.
Customer Service Representative
Humana
Florida
10.2022 - 01.2023
- Answered customer inquiries and provided accurate information regarding products and services.
- Collected customer feedback through surveys to inform enhancements in customer service.
- Documented customer interactions, transactions, and comments to support service quality and continuity.
Education
High School Diploma -
Cypress Lakes High School
Katy, TXSkills
- Claims processing
- Insurance verification
- Billing inquiries management
- Document processing
- Account maintenance
- Complaint Resolution
- Consultative Sales
- Call Management
- Inbound and Outbound Calling
- Data Collection
- Data entry
- Problem-Solving Abilities
- Appointment Scheduling
- Information Security
Timeline
Customer Service Representative
Humana
10.2022 - 01.2023
Insurance Claims Specialist
Humana
01.2021 - 01.2024
Customer Service Representative
Just energy
04.2020 - 12.2023
High School Diploma -
Cypress Lakes High School