Destiny Simmons
Sunshine ,US
Summary
Experienced and versatile professional with 5+ years of diverse experience in medical claims processing, administrative support, and customer service. Adept at navigating complex medical billing and coding systems, processing claims accurately and efficiently. Excellent communication and problem-solving skills with a track record of providing exceptional customer service and support. Skilled in data entry, file management, scheduling, and other administrative duties. Proficient in Microsoft Office suite and various medical billing software.
Overview
7
7
years of professional experience
Work History
Customer Care Representative
MTM Transportation
06.2025 - Current
- Managed high volume of incoming calls to provide customer support and resolve inquiries efficiently. Helped maintain positive customer relationships through effective communication. Assisted team in achieving service level targets by handling calls promptly.
- Executed insurance verification processes to ensure accurate patient billing.
- Implemented appointment verification processes to enhance accuracy and reliability.
- Orchestrated transportation scheduling to ensure timely arrivals and departures.
- Executed Medicaid and Medicare verification processes to ensure compliance and accuracy.
Healthcare Customer Service Representative
Humana
01.2023 - 05.2025
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Ensured accurate record-keeping with diligent data entry and database management for vital company information.
- Resolved patient billing issues in line with established guidelines.
- Remote
Claims Processing Specialist
Concentrix
10.2020 - 12.2022
- Leveraged advanced software tools to quickly identify discrepancies, leading to more accurate claims decisions.
- Improved claim processing efficiency by implementing streamlined procedures and workflow adjustments.
- Participated in ongoing professional development programs within the industry, staying current on best practices for efficient claims management.
- Remote
Senior Claims Processing Specialist
Conduent
11.2019 - 10.2020
- Maintained a high level of accuracy and attention to detail when reviewing submitted claims for completeness and correctness, contributing to the overall quality of processed claims.
- Identified potential fraudulent claims through careful analysis of trends, patterns, and inconsistencies.
- Managed high-volume workloads while maintaining strict deadlines for claim submissions and resolutions.
- Remote
Education
High School Diploma - undefined
East Iberville
St. GabrielPharmacy Tech -
Fortis College
Baton Rouge, LA09.2019
Skills
- Claims Processing, HIPAA, Data Analysis, Customer Service, Administrative Support, Insurance Verification, Patient Advocacy, Compliance Management, Prior Authorization, Microsoft Office, Technical Support, Windows 10, Patient Transportation Scheduling, Medicaid Verification, Appointment Scheduling, Product Troubleshooting
ADDITIONAL INFORMATION
- Key Achievements
- Achieved a 98% customer satisfaction rate based on post-claim surveys
- Reduced fraud by 20% through data analysis and investigation
- Processed over 500 claims per month with a 95% accuracy rate
Timeline
Customer Care Representative
MTM Transportation
06.2025 - Current
Healthcare Customer Service Representative
Humana
01.2023 - 05.2025
Claims Processing Specialist
Concentrix
10.2020 - 12.2022
Senior Claims Processing Specialist
Conduent
11.2019 - 10.2020
High School Diploma - undefined
East Iberville
Pharmacy Tech -
Fortis College