CLARISSA SPRIGGS
Topeka
Summary
Healthcare professional with a solid foundation and extensive experience in patient care coordination, data entry, and healthcare claims processing.
Overview
8
8
years of professional experience
Work History
Patient Care Coordinator
Carenet
01.2026 - Current
- answer high volume after hour inbound calls for over 700 different facilities/health plans navigating multiple systems
- triage nurse advise line calls
- create chart notes for on call registered nurses for red flag and non red flag patients
- page on call Doctors for patients
- send after hour provider and general messages to facilities from patients
- schedule emergency transportation rides
- provide customer service for after hour member services
Medical Claims Specialist
VXI Global
04.2024 - 01.2026
- reviewed claim documentation for data accuracy and completeness to verify patient eligibility and policy coverages
- review ICD-10 and CPT codes for accuracy to authorize or deny coverage for payments
- verify patient insurance coverage
- communicate with facilities and providers regarding claim accuracy and status
Customer Success Specialist
Constant Contact
10.2022 - 04.2024
- answer high volume of inbound calls, chats and emails from small business owners and nonprofit agencies assisting them with the platform.
- trouble shoot the platform and basic HTML issues
- assist with creating landing pages, list segmentation, marketing emails, events, and social media ads
- explain clients engagement results and anlytics
DUAL CSR AND MEDICARE CLAIMS A/B1 REP
Maximus Federal
Lawrence, KS
08.2018 - 04.2022
- Answered a high call volume assisting Medicare beneficiaries with claims, doctor selection, drug plan enrollment, and general questions about benefit coverage.
- Demonstrated excellent customer service skills by actively listening and showing empathy and understanding to beneficiaries in difficult health situations.
- dual trained to receive calls from Marketplace consumers assisting them with enrolling into Marketplace insurance plans and assisting with general technical account issues and questions.
- Promoted again at 6 months to handle Medicare Part A and B claims calls.
- responsible for accurately researching processed Medicare claims that were either approved or denied.
- Received outstanding CSAT scores, reflecting customer satisfaction and service quality
Education
No Degree - Pharmacy Tech
Penn Foster
Chandler, AZ08-2026
High School Diploma - undefined
McLouth High School
McLouth, KS05-2003
Skills
- Insurance verification
- Detail-oriented
- Medical terminology
- Co-payment collection
- Insurance authorization
- Creative problem solving
- Customer service
- Active listening
- Critical thinking
- Data entry
- Basic medical terminology
- Appointment scheduling
- Patient care coordination
- Medical billing
- Claim appeals handling
- Medical record review
- Insurance claims processing
- Microsoft Office
Accomplishments
A member of the National Society of Leadership and Success. You must have a 3.0 GPA or higher, be nominated by a faculty member, and show leadership qualities. Less than 20% of students achieve this award/nomination. At request a personalized letter of recommendation can be provided!
Timeline
Patient Care Coordinator
Carenet
01.2026 - Current
Medical Claims Specialist
VXI Global
04.2024 - 01.2026
Customer Success Specialist
Constant Contact
10.2022 - 04.2024
DUAL CSR AND MEDICARE CLAIMS A/B1 REP
Maximus Federal
08.2018 - 04.2022
High School Diploma - undefined
McLouth High School
No Degree - Pharmacy Tech
Penn Foster