Summary

Overview

Work History

Education

Skills

Timeline

Deborine C. Lane

Las Vegas,NV

Summary

Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.

Overview

years of professional experience

Work History

Fraud Analyst

TTEC

Las Vegas , NV

10.2023 - Current

Assessed customer and client data to detect potential fraud risks.
Reviewed customer profiles for any changes that may indicate fraudulent activities.
Investigated cases of suspected fraudulent activities, including tracing money trails and analyzing documents.
Conducted reviews of flagged transactions and reports that showed potential suspicious activity.
Collaborated with other departments on investigations as needed to review evidence, analyze data, and prepare reports for management.
Analyzed and reviewed confidential and highly sensitive investigative material concerning various parties.

Patient Account Services Rep

ACCLARA

Houston, TX

06.2022 - 09.2022

Deliver high-quality patient experience through inbound and outbound call resolution within established protocols and a first call resolution
Accurately receive and process electronic payments from patients
Identify customers’ needs by, clarifying information, researching, and providing solutions
Review, Interpret Patient Statements/EOB and Balance and basic knowledge of Client Contractual Terms/Agreements (as needed)
Obtain supporting documentation regarding Patient/Client follow-up efforts
Identify contractual and administrative adjustments
Assist and Resolve Patient Inquiries/Request within 24–48-hour period.
Meet personal/team qualitative and quantitative metrics

Digital Personal Shopper

WALMART

Houston, TX

07.2020 - 06.2022

Maintained a high level of customer service while ensuring customer satisfaction.
Scanned items when pulling from shelves to update system stock information.
Developed relationships with loyal shoppers by providing personalized shopping experiences.
Listened to customer needs to identify and recommend best products and services.

Call Center/Customer Service Rep

Metasense

West Berlin, NJ

11.2018 - 03.2019

Handled inbound inquiries from members, pharmacies, and prescribers in its Philadelphia Contact Center, maintaining the standard for service levels, including research of relevant issues; and meeting all performance standards required of the position
Interacted with customers in a courteous and professional manner
Effectively communicate issues and resolutions to customers and appropriate internal staff
Answer prior authorization inquiries calls as well as research and resolve benefit issues
Reviewed utilization requests and appeals.

Medicare Secondary Payer Recovery Contractor Specialist

Emblem Health Care

New York, NY

01.2006 - 01.2014

Charged with guiding case workload with minimal supervision, effectively interpreting federal law and Centers for Medicare and Medicaid Services (CMS) instructions in making sound decisions
Determine potential secondary payer interest by compiling data from Medicare records, beneficiaries, providers, attorneys, and employers and other 3rd party
Reviewed and processed correspondence from attorneys, policyholders, adjusters and other parties related to the claim.
Analyzed financial data to determine potential liability of third-party entities.
Managed a high volume caseload while meeting deadlines.
Examined policies with third-party liability, accident benefits and collision benefits.

Patient Account Representative

Rural Metro Ambulance

Syracuse, NY

01.2004 - 01.2006

Provided customer service to patients regarding billing inquiries and account information.
Analyzed claims denials from third party payers and identified potential solutions for reimbursement.
Reviewed EOBs statements submitted by insurance companies for accuracy against provider's charges.
Maintained detailed notes on all patient interactions for future reference purposes.
Initiated collection activities on delinquent accounts while adhering to HIPAA guidelines and regulations.

Customer Service Representative

Contemporary Personnel Staffing

Liverpool, NY

12.2003 - 03.2004

Advised claimants on withholdings and taxable benefits and distributed W-2 forms
Prepared invoices, reports, memos, letters, financial statements, and other documentation
Maintained up-to-date knowledge of all current developments in taxation law, regulation, policy or practice.

Personnel Specialist

US Army Reserve

Edison , NJ

07.1982 - 02.1988

Administrative and Personnel Specialist Guiding wide range of office operations, including payroll, staff supervision, and recordkeeping
Honorably discharged.