Dorothy Buie
Tampa,FL
Summary
Strong leader and problem-solver dedicated to streamlining operations to decrease costs and promote organizational efficiency. Uses independent decision-making skills and sound judgment to positively impact company success. Well versed insurance professional experienced in investigating and processing insurance claims. Motivated to succeed in fast-paced and deadline-driven professional environment.
Overview
7
7
years of professional experience
Work History
Customer Service Representative
Maximus Federal Services
Work From Home, FL
05.2022 - Current
- Working inside the health insurance field ..
- I would get calls from callers wanting to sign up &
- see if they qualify for affordable help none as Obama care & than I’ll help the caller through the application process once they qualify
- I’ll go over plan & prices & enroll them into the insurance company they would like.
- Also helping with tax questions regarding their 1095 A & their 8962 form.
Claims/Denials Coordinator
General Dynamics Information Technology
Tampa
09.2018 - 06.2021
- Maintained knowledge of insurance coverage benefit levels, eligibility systems and verification processes.
- Followed up on denied and unpaid claims to resolve problems and obtain payments.
- Identified root cause of denials to provide plans for denial resolution.
- Coordinated with insurance providers to verify customer's policy benefits in relation to claims.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
Customer Service | Billing Specialist
Rooms To Go
Seffner, FL
08.2017 - 09.2018
- Assisted with billing inquiries and provided timely responses to enhance customer satisfaction.
- Provided excellent customer service, developing and maintaining client relationships.
- Worked productively in fast-moving work environment to process large volumes of furniture claims.
- Researched and analyzed complex claims to determine next steps and possible outcomes.
- Examined reports, accounts, and evidence to determine integrity and accuracy of information.
Education
Diploma -
Middleton High School
Tampa, FLSkills
- Effective Customer Care
- High-Volume Environments
- Order and Refund Processing
- Quality Control Policies
- Appeals & Grievance
- Provider Relations
- Data Entry Excellence
- Document and Records Management
- Investigate Claims
- Process Transactions
- Policy and Procedure Adherence
- Outbound Calls
- Customer Data Confidentiality
- Issue and Complaint Resolution
- Billing Adjustments and Refunds
- Livechat Messaging
- Liability Denials
- Production Goals
- Negotiation Leadership
- Special claims Handling
- Complex Coverage Issues
- Billing Software
- Policy Requirements and Eligibility
- Secure Data Practices
- Work Organizing and Prioritizing
Timeline
Customer Service Representative
Maximus Federal Services
05.2022 - Current
Claims/Denials Coordinator
General Dynamics Information Technology
09.2018 - 06.2021
Customer Service | Billing Specialist
Rooms To Go
08.2017 - 09.2018
Diploma -
Middleton High School