Destiny Scott
Greensboro,NC
Summary
Tenacious Representative possessing dynamic interpersonal expertise for developing fruitful customer relationships. Adept mediator of client requirements and organizational interests promoting mutually beneficial deals. Focused communicator fostering favorable service applications for maximizing customer interest and satisfaction. Reliable business professional with experience in project management, process improvement and financial analysis. Proven track record of successfully streamlining business operations and reducing costs. Adept at analyzing data to identify trends and developing strategies to improve efficiency.
Overview
6
6
years of professional experience
Work History
Benefits Verification Representative
Continuum Global Solutions
07.2021 - Current
- Contact insurance companies and customers to verify eligibility and benefits for patients needing medical services
- Utilize HIPAA to document and maintain all information related to patient’s insurance eligibility, benefits, insurance updates/changes, coordination of benefits for primary and secondary plans, as well as correspondence by and between Continuum Services and applicable payors/plans
- Support submission of prior authorization requests for new and ongoing services, as well as requests for patient-specific LOA/SCAs either directly or indirectly by working with Authorization/LOA Specialists
- Files appeals for denied benefits coverage to insurance companies as needed
- Coordinates and communicates with other departments as needed to obtain necessary information to complete eligibility and benefit verification, authorization, appeals and documents outcomes for services of care
- Process claims and performs other related duties as assigned.
Medical Claims Processor
Elevance Behavioral Health
Greensboro
10.2023 - 01.2024
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Verified patient insurance coverage and benefits for medical claims.
- Monitored and updated claims status in claims processing system.
- Increased claim processing efficiency by implementing new software and streamlining workflows.
- Reduced errors in claims submissions through meticulous attention to detail and thorough review processes.
Customer Service Representative
Continuum Global Solutions
11.2020 - 07.2021
- Actively listened to customers to understand concerns
- Provided information about their current plans and products
- Identified and position new solutions that align with their needs
- Navigated through multiple computer applications with speed and accuracy
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
Merchandising /Customer Service
Belk
08.2017 - 11.2020
- Performed the process of unloading and sorting merchandise cartons received on trailers
- Performed merchandise unpacking and unwrapping to ensure readiness for merchandising on the sales floor
- Ensured the cleanliness of the receiving area following processing on truck days
- Exhibited a warm and friendly demeanor when helping customers and ensured that their needs were met
- Ran cash register when needed.
- Enhanced customer experiences by providing timely and accurate information on products and services.
- Resolved customer complaints with empathy, resulting in improved satisfaction ratings.
Education
Medical Office Assistance
Southside Community College
South Boston, VADiploma -
Halifax County High
2015
Skills
- Time Management
- Medical Terminology
- Customer Service
- Adaptability
- Data Entry
- Claims Processing
- Knowledgeable in Software
- HIPAA
- Insurance Claims
- Thorough Claims Reviews
- Telephone Etiquette
- Insurance Claims Processing
- Medical Terms and Procedure Knowledge
- Small Claims Payouts
- Teamwork and Collaboration
- Claims Adjustment
- Records Management
- Paperwork Processing
Timeline
Medical Claims Processor
Elevance Behavioral Health
10.2023 - 01.2024
Benefits Verification Representative
Continuum Global Solutions
07.2021 - Current
Customer Service Representative
Continuum Global Solutions
11.2020 - 07.2021
Merchandising /Customer Service
Belk
08.2017 - 11.2020
Medical Office Assistance
Southside Community College
Diploma -
Halifax County High