Diamond Bennett-Hightower
Pittsburgh,PA
Summary
Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires, and providing customized solutions to build loyalty. A professional with extensive experience in managing client interactions and ensuring high satisfaction levels. Proven ability to collaborate effectively with diverse teams and adapt to changing demands. Recognized for conflict resolution and communication skills, consistently delivering positive outcomes.
Overview
10
10
years of professional experience
Work History
Claims Processor
Novitas Solutions
10.2024 - Current
- Evaluated accuracy and quality of data entered into agency management system.
- Enhanced claim processing efficiency by implementing new software and streamlining procedures.
- Maintained detailed records of all processed claims for easy retrieval during audits or disputes.
- Reviewed applications and supporting documents to verify claims eligibility and accuracy.
- Maintained strict confidentiality when dealing with sensitive information about patients'' medical histories or personal details.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Maintained confidentiality of patient finances, records, and health statuses.
- Reduced backlog of pending claims, prioritizing tasks effectively and efficiently.
- Ensured compliance with all regulatory requirements, staying up-to-date with changes and conducting regular training.
- Improved speed and accuracy of data entry, utilizing advanced software and technology to support claims processing.
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Excellent communication skills, both verbal and written.
- Worked well in a team setting, providing support and guidance.
- Passionate about learning and committed to continual improvement.
Radiology Outpatient Scheduler CSR
Allegheny Health Network
01.2019 - 03.2024
- Schedule outpatient radiology and medicine appointments ensuring compliance with safety and HIPAA guidelines
- Utilize software programs to resolve customer inquiries effectively
- Maintain department productivity levels and escalate issues as needed
- Access multiple systems efficiently to perform duties and support team goals
- Deliver exceptional customer service, addressing client needs with empathy
- Adapt to new software tools to enhance operational efficiency
Food Service Liaison
Mercy Hospital
01.2017 - 01.2019
- Ensured timely meal service, maintaining food quality and temperature, enhancing patient satisfaction
- Fostered effective communication with healthcare team, promptly addressing customer concerns
- Adapted swiftly to new food service equipment procedures demonstrating versatility
- Proposed improvements to service workflow, enhancing departmental efficiency
- Ensured proper patient identification
Customer Service Representative
PNC BANK
01.2015 - 01.2017
- Investigated and resolved customer account and billing inquiries, recommending appropriate solutions
- Maintained detailed documentation of customer interactions
- Empowered customers by providing tailored solutions
- Implemented creative problem-solving techniques to address recurring issues
Education
High School -
Penn Hills High School
01.2015
Skills
- Customer Service
- Software Utilization
- Productivity Maintenance
- Issue Escalation
- Multi-system Access
- Empathy
- Software Adaptation
- Technical Support
- Medical Terminology
- HIPAA Compliance
- Policy Enforcement
- Time Management
- Inbound Calling
- Outbound Calling
- Typing Proficiency
- Clerical Duties
- Verbal Communication
- Written Communication
- Call Center Experience
- Claims review
- Accuracy and precision
- Claims
- Claims processing software
- Professionalism and ethics
- Medical terminology
- Data entry proficiency
- Critical evaluation
- Attention to detail
- Records management
- Data entry
- Critical thinking
- Active listening
- Microsoft office
- Customer service
- Eligibility determination
- Organizing and prioritizing work
- Prior authorization processing
- Data entry software
Timeline
Claims Processor
Novitas Solutions
10.2024 - Current
Radiology Outpatient Scheduler CSR
Allegheny Health Network
01.2019 - 03.2024
Food Service Liaison
Mercy Hospital
01.2017 - 01.2019
Customer Service Representative
PNC BANK
01.2015 - 01.2017
High School -
Penn Hills High School
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