DESIREE BANKS
CIGNA
Houma,LA
1
Certification
9
years of professional experience
Healthcare chat operations professional with over 8 years of experience supporting patients, providers, and health plans in fast-paced healthcare environments. Extensive background in medical and dental claims, prior authorizations, insurance verification, benefits investigation, and patient access with expertise in Epic and HIPAA compliance. Recognized for strong communication, attention to detail, problem-solving skills, and consistently delivering accurate, high-quality service while managing complex healthcare processes.
Work History
Senior Chat Representative (Medical and DentalChat)
3 Years 2 Months- Provide real-time support to members through a high-volume medical and dental chat platform, taking dual chats, assisting with claims, eligibility, benefits, and coverage questions while maintaining exceptional customer satisfaction and quality standards.
- Resolve complex medical claims, eligibility, and benefit inquiries with accuracy and professionalism.
- Research member accounts and explain health plan benefits, policies, and coverage options.
- Collaborate with providers and internal departments to resolve escalated issues promptly.
- Maintain detailed documentation while ensuring HIPAA compliance.
- Consistently meet productivity, quality, and performance metrics in a fast-paced remote environment.
- Remote
Preservice Representative
5 Years 8 Months- Managed the prior authorization process for outpatient and surgical procedures while working closely with providers, insurance companies, and patients to ensure timely approvals and continuity of care.
- Processed and submitted prior authorization requests for multiple insurance carriers.
- Verified insurance eligibility, benefits, and authorization requirements.
- Utilized Epic to document authorization activities accurately.
- Communicated with physician offices, patients, and insurance representatives regarding authorization status.
- Reduced treatment delays through timely follow-up and efficient case management.
- Maintained compliance with payer guidelines, HIPAA regulations, and organizational policies.
- Remote
Education
High School Diploma - Equivalent
Skills
Medical Claims
Prior Authorizations
Insurance Verification
Benefits Investigation
Appeals & Denials
Patient Access
Epic EHR
HIPAA Compliance
Provider Relations
Revenue Cycle Support
Customer Service
Microsoft Office
Certification
- Epic Electronic Health Record (EHR)
- HIPAA Compliance
- Medical Claims Processing
- Dental claims processing
- Prior Authorization & Insurance Verification
- Customer Service Excellence
Timeline
Senior Chat Representative (Medical and DentalChat)
CIGNA
06.2023 - 08.2026Read More
Preservice Representative
OCHSNER HEALTH SYSTEM
09.2017 - 05.2023Read More
High School Diploma from Equivalent
Read More