Dionche Carroll
Spring,Tx
Summary
Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Overview
4
4
years of professional experience
Work History
Patient Access Representative
HCA
Remote
08 2023 - 02 2026
- Answer inbound calls and make outbound calls related to patient scheduling, registration, and service inquiries. Triage patient needs and route calls to
appropriate departments. - Verify patient insurance eligibility, benefits coverage, and co-pay/deductible requirements. Contact insurance companies and use payer portals for up-to- date benefits information.
- Obtain and track prior authorizations and referrals for procedures, diagnostics, and specialist visits. Follow up with providers and payers to avoid delays in patient care.
- Assist uninsured patients in exploring Medicaid, charity programs, or financial aid options. Provide front-end support for patient billing inquiries.
Medical Claims Specialist/Claims Reimbursement Specialist
Med Data
Remote
12.2021 - 08.2023
- Processed and reviewed high volumes of inbound medical claims for accuracy, completeness, and compliance with payer guidelines and healthcare regulations (Medicare, Medicaid, commercial insurance).
- Resolved claim denials, rejections, and underpayments by researching discrepancies and initiating appeals or resubmissions as necessary.
- Handled inbound calls from patients, providers, and payers regarding reimbursement status, claim explanations (EOBs), and payment disputes.
- Verified insurance eligibility, benefits, authorizations, and coverage details to ensure proper reimbursement and billing practices.
Benefits Enrollment Specialist
Priority Health
Remote
09.2019 - 12.2021
- Respond to inbound calls and emails from members regarding benefits enrollment. Guide members through the benefits selection and enrollment
process. - Explain health plan options, coverage details, eligibility criteria, and deadlines. Accurately enter and update member information in enrollment systems.
- Process new enrollments, terminations, changes in coverage, and qualifying life events. Educate members on available health plans (e.g., HMO, PPO, Medicare/Medicaid options).
- Resolve enrollment-related issues, discrepancies, or complaints promptly and professionally. Collaborate with internal teams such as billing, claims, and
provider services to support member needs.
Data Entry Clerk
TransCore
02 2026 - 05 2026
- Verified accuracy of data entered into system to produce error-free reports.
- Maintained a high level of accuracy and speed through continuous self-assessment, surpassing company standards consistently.
- Entered data into various computer systems accurately using Microsoft Office Suite.
- Communicated with supervisors and colleagues to process data quickly and resolve discrepancies.
Education
High School Diploma
Skills
- Medicare expertise
- Claims processing
- Insurance verification
- EOB analysis
- Medicaid
- COB
- Customer service
- Chat Support
- Epic
- CPT, CDT, ICD-10, HCPCS Codes
- Medical billing
- Revenue cycle management
- Email Support
- Data Entry
- Eligibility determinations
- Chat Support
- Health insurance
- Remote Operations
- Exceeding Customer Expectations
- Benefits explanation
- Benefit Verifications
- Eligibility procedures
- Medicaid
- Appointment scheduling
- Call center experience
- Paging Systems
- Insurance billing
- Information Collection
Timeline
Medical Claims Specialist/Claims Reimbursement Specialist
Med Data
12.2021 - 08.2023
Benefits Enrollment Specialist
Priority Health
09.2019 - 12.2021
Patient Access Representative
HCA
08 2023 - 02 2026
Data Entry Clerk
TransCore
02 2026 - 05 2026
High School Diploma