Dominique McGee
Abilene,TX
Summary
Skilled claims processing professional with extensive experience in reviewing and validating insurance claims. Strong focus on accuracy, problem-solving, and effective communication. Known for collaborative approach and adaptability to changing needs. Proficient in claims software, data entry, and customer service. Recognized for reliability and achieving results in team environments.
Overview
6
6
years of professional experience
Work History
TurboTax Product Expert
Working Solutions
01.2025 - 04.2025
- Solid understanding of tax laws, regulations, and filing requirements to accurately answer complex tax questions.
- Ability to diagnose customer issues, troubleshoot software problems, and find solutions to complex tax scenarios.
- Extensive experience providing one-on-one customer support via phone, chat, or video conferencing, effectively addressing customer concerns and guiding them through tax preparation using TurboTax.
- Demonstrated proficiency in navigating TurboTax features, including forms, calculations, deductions, and filing processes.
Customer Experience Associate II
Conduent
11.2023 - 01.2025
- Answer high-volume inbound customer calls for Large Pharmaceutical Company Patient Assistance Program.
- Make outbound calls to Patients/Health Care Provides as required to address questions/inquires and completion of required program application/documentation.
- Utilize program training and resources to address/answer patient/HCP program related questions/issues.
- Complete required application and/or reorder documentation as required.
- Communicate effectively and professionally with patients, teammates, healthcare professionals, and patients at all time.
- Consistently meet and attain required Agent Performance Goals/KPIs.
- Adherence to Work Schedule and Attendance Policies.
- Perform other duties as required.
- Processing incomplete claims.
- Cancelling orders/claims.
- Managing emails from onshore and offshore team.
- Make outbound calls to Healthcare Providers to get necessary information to finish processing claims.
FEP Claim Technician
Health Care Service Corporation
05.2023 - 11.2023
- Maintain a working understanding of medical terminology and CPT, HCPCS, and ICD10 coding.
- Research and identify other insurance, Medicare, Medicaid and update patient file as needed.
- Resolve complex pended claims, duplicate claims and adjustments.
- Process claims, EOBS, involving communications with participating plans and/or Service Units. Resolve various issues.
- Read appropriate files in IMAGE and apply information to claims as needed using the Financial Suspense System (FSS).
- Access resource materials and support files in order to process and adjudicate claims timely and accurately.
- Ability to understand billing and field locations and definitions of UB04.
- Ability to correctly bill or request billing for various insurances.
- Proficient knowledge of payer portals.
- Ability to accurately read and interpret EOBs (understand CARC/RARC codes).
- Proficient knowledge of value codes, condition codes and modifiers.
- Medicare claim resolution.
- Possess verifiable knowledge of managed care protocols for coverage, based on illness/injury and whether provider is in or out of network.
- Possess in-depth understanding of claim denials and actions required for insurance payment/resolution.
- Meet metrics for claims.
Service Center Representative
SEDGWICK CLAIMS MANAGEMENT SERVICES INC
11.2022 - 03.2023
- Assisted customers with a warm and professional attitude.
- Assisted customers with questions.
- Kept records of customer complaints.
- Handled emails, high volume inbound calls, and outbound calls.
- Managed customer accounts.
- Monitored claims and physician-related services.
- Performed data entry for customer information.
Pharmacy Service Representative
Teleperformance
12.2021 - 11.2022
- Assisted customers with a warm and professional attitude.
- Processed orders and customer transactions.
- Assisted customers with questions.
- Interacted with customers through live chat.
- Kept records of customer complaints.
- Handled emails, inbound calls, and outbound calls.
- Managed customer accounts.
- Performed data entry for customer information, shipments and orders.
- Handled billing issues and order inquiries.
Sales Associate
Dillards
06.2019 - 10.2021
- Responsible for retail sales.
- Consistently met or surpassed quotas of 30000 sales per month.
- Built personal relationships with customers.
- Successfully negotiated sales of over 2000 dollars.
- Handled all prospective customer correspondence, including calls, emails and sms.
- Resolved register transaction issues.
- Provided exceptional customer service.
- Stocked shelves.
- Provided customer support.
- Negotiated and completed purchasing contracts.
Education
High School - undefined
Abilene High School
Abilene, TX06.2013
Skills
- Writing skills
- Retail sales
- Workday
- Claims Processing
- Clerical experience
- Medical documentation
- EOB
- Insurance Verification
- Sales
- Customer support
- Organizational skills
- Medical terminology
- Merchandising
- Retail management
- IVR
- Management
- HIPAA
- Negotiation
- Typing
- ICD-10
- Medical claims
- Workers' compensation law
- Data analytics
- Customer service
- Documentation review
- Medical Billing
- Communication skills
- Store management
- Data collection
- Requirements gathering
- CPT Coding
- Upselling
- Live Chat
- Stocking
- Microsoft Word
- Microsoft Excel
- Attention to detail
- Data accuracy
- Accuracy and attention to detail
- Time management
- Word processing
- Problem-solving
- Maintains confidentiality
- Strong problem solver
- Data processing
- Document processing
- Document scanning
- Work prioritization
- Proofreading
- Order processing
- Bookkeeping
- Record preparation
- Information security
- Data security
- Medical billing
- Insurance processing
- Basic math
- Insurance eligibility
- Verbal and written communication
- Adaptability and flexibility
- Record keeping
- 10-key entry
- Numerical data entry
- Proficient with database
- Collecting information
- Excellent communication skills
- Verifying data accuracy
Personal Information
- Visa Status: Authorized to work in the US for any employer
- Work Permit: Authorized to work in the US for any employer
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimeWork Location
RemoteImportant To Me
Career advancementWork-life balanceFlexible work hoursHealthcare benefitsWork from home optionPaid sick leave401k matchPaid time offCompany CultureTimeline
TurboTax Product Expert
Working Solutions
01.2025 - 04.2025
Customer Experience Associate II
Conduent
11.2023 - 01.2025
FEP Claim Technician
Health Care Service Corporation
05.2023 - 11.2023
Service Center Representative
SEDGWICK CLAIMS MANAGEMENT SERVICES INC
11.2022 - 03.2023
Pharmacy Service Representative
Teleperformance
12.2021 - 11.2022
Sales Associate
Dillards
06.2019 - 10.2021
High School - undefined
Abilene High School
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