EBONY Nettles
Snow Camp,NC
Summary
Detail-oriented Healthcare Claims Representative with 5 years of experience processing insurance claims in high-volume environments. Proven ability to maintain 99%+ accuracy, analyze complex claim data, and ensure compliance with eligibility guidelines and internal policies. Skilled in navigating multiple systems, validating documentation, and resolving discrepancies efficiently in remote environments. Recognized for strong productivity, attention to detail, and commitment to quality outcomes.
Overview
3
3
years of professional experience
2
2
years of post-secondary education
Work History
Claims Processor / Administrative Specialist
Cohere health
Snow Camp, North Carolina
01.2023 - Current
- Processed insurance claims daily while maintaining 100% accuracy and compliance standards
- Reviewed claim documentation to verify eligibility and required authorizations, facilitating timely approvals
- Investigated discrepancies and resolved claim errors using established procedures
- Collaborated with team members to resolve claim discrepancies efficiently.
- Navigated multiple systems simultaneously to validate claim details and improve workflow efficiency
- Maintained productivity and quality benchmarks in a fast-paced, metrics-driven environment
- Collaborated with supervisors and team members to enhance processing accuracy, contributing to overall team performance
- Communicated with clients to gather necessary information for claims.
- Maintained detailed records of all processed claims for auditing purposes.
Customer Service / Administrative Role
Cohere health
Snow Camp, North Carolina
01.2023 - Current
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Maintained accurate records of transactions and interactions to support efficient service delivery
- Maintained accurate records of transactions and interactions
- Identified and escalated complex issues for prompt resolution, ensuring minimal disruption to customer experience
- Identified and escalated complex issues for timely resolution
- Met performance goals for accuracy, response time, and service quality
- Worked successfully with a diverse group of coworkers to accomplish goals and address issues related to our products and services.
- Resolved customer problems with knowledgeable and friendly service, contributing to high customer satisfaction levels
Education
Associate of Science - Medical Office Administration
Randolph Community College
Asheboro , NC 06.2024 - 06.2026
Skills
- Claims Processing & Adjudication
- Medical Coding (CPT, ICD-10)
- Insurance Eligibility & Benefits Verification
- Coordination of Benefits (COB)
- Microsoft Outlook (Email, Calendar, Attachments)
- Microsoft Excel (Sorting, Filtering)
- Data Entry (25–50 WPM)
- Multi-System Navigation & Workflow Optimization
- Webex, Teams, Zoom (Virtual Collaboration)
- HIPAA Compliance & Data Security
Remote Work Capabilities
- Proven ability to work independently in a remote environment
- Hardwired high-speed internet (meets/exceeds 25/10 Mbps)
- Secure, distraction-free workspace
- Strong time management and task prioritization skills
- Comfortable using multiple systems and virtual tools simultaneously
Education Certifications
- High School Diploma / GED, School Name, City, State
- Medical Billing & Coding Certificate
- Healthcare Administration Courses
- [XX WPM]
Websites
Remote Ready Technical Skills
- Claims Processing & Adjudication
- Medical Coding (CPT, ICD-10)
- Insurance Eligibility & Benefits Verification
- Coordination of Benefits (COB)
- Microsoft Outlook (Email, Calendar, Attachments)
- Microsoft Excel (Sorting, Filtering)
- Data Entry (25–50+ WPM)
- Multi-System Navigation & Workflow Optimization
- Webex, Teams, Zoom (Virtual Collaboration)
- HIPAA Compliance & Data Security
Keywords
- Claims processing
- CPT / ICD-10
- Eligibility verification
- Accuracy
- Productivity
- Documentation review
- Discrepancy resolution
- Multi-system navigation
- Remote work
Timeline
Associate of Science - Medical Office Administration
Randolph Community College
06.2024 - 06.2026
Claims Processor / Administrative Specialist
Cohere health
01.2023 - Current
Customer Service / Administrative Role
Cohere health
01.2023 - Current