Summary
Overview
Work History
Education
Skills
Timeline
Generic

Delicia Ridley

North Chesterfield,VA

Summary

Highly motivated and detail-oriented Healthcare Customer Service Professional with over 10 years of experience in payer coordination, audit tracking, claims resolution, and medical transportation services. Adept at working with insurance companies, clinical teams, and patients to ensure timely follow-up on accounts, accurate audit documentation, and denial resolution. Skilled in navigating healthcare systems, documenting actions, and maintaining compliance with HIPAA and industry regulations. Proficient in Microsoft Office Suite, data entry, and patient account systems. Proven track record in meeting productivity goals and quality metrics.

Overview

15
15
years of professional experience

Work History

Medical Transportation Coordinator / Independent Contractor

Liveops
Richmond, VA
12.2020 - Current
  • Track, verify, and coordinate non-emergency medical transportation for members in compliance with insurance and healthcare regulations.
  • Communicate with hospital staff, provider offices, and members to confirm eligibility, appointment details, and transportation requirements.
  • Document trip details and patient notes in internal systems, maintaining accuracy and data integrity.
  • Collaborate with dispatch teams and transportation vendors to resolve scheduling, cancellations, or urgent requests.
  • Ensure HIPAA compliance while handling sensitive patient and trip information.
  • Meet and exceed performance benchmarks for quality assurance, customer satisfaction, and documentation accuracy.

Healthcare Customer Service Representative

Anthem
Richmond, VA
12.2015 - 12.2020
  • Resolved complex claim issues, reviewed member benefits, and assisted with financial account inquiries related to insurance coverage.
  • Routinely followed up with payers and internal departments to gather decision letters and documentation needed for audit-related disputes.
  • Documented case progress in patient account systems and escalated denial cases to Appeals and Billing departments when required.
  • Helped identify and escalate problematic claims and accounts, contributing to trend reporting and process improvement.
  • Maintained accurate data entry, audit trail, and compliance with payer and corporate policies.

Customer Support Representative – Financial & Healthcare Services

Teleperformance
Richmond, VA
12.2010 - 12.2015
  • Handled customer concerns regarding account balances, billing discrepancies, and benefits coverage.
  • Processed transactions and submitted accurate claim-related updates within internal account systems.
  • Identified recurring account issues and reported trends to management for resolution.
  • Maintained service quality while adhering to regulatory requirements and organizational policies.

Education

Medical Billing & Coding Certificate -

Centura College
Richmond, VA

High School Diploma -

Connelly Trade School
Pittsburgh, PA

Skills

  • Audit Follow-up & Documentation
  • Denial Management & Appeals Routing
  • Claims Processing & Payer Coordination
  • Financial Account Review
  • HIPAA Compliance
  • Microsoft Excel & Outlook
  • High-volume Data Entry
  • Communication & Interdepartmental Collaboration
  • Microsoft Office (Excel, Word, Outlook)
  • Audit Tracking Systems
  • Patient Account Documentation
  • 10-Key Data Entry
  • Claims Management Software
  • CRM / Call Center Platforms

Timeline

Medical Transportation Coordinator / Independent Contractor

Liveops
12.2020 - Current

Healthcare Customer Service Representative

Anthem
12.2015 - 12.2020

Customer Support Representative – Financial & Healthcare Services

Teleperformance
12.2010 - 12.2015

Medical Billing & Coding Certificate -

Centura College

High School Diploma -

Connelly Trade School

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