ElizeBeth Bonz
Overview
8
8
years of professional experience
Work History
Health Insurance Claims Adjudicator
Blue Care Network Of Michigan
03.2023 - Current
- Safeguarded patient confidentiality during the adjudication process by adhering to HIPAA guidelines and ensuring secure storage of personal information.
- Developed comprehensive understanding of medical terminology, coding systems, and billing procedures for accurate claim processing.
- Reduced error rates in claims adjudication through meticulous attention to detail and thorough documentation review.
- Maintained compliance with industry regulations and company policies while adjudicating health insurance claims.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Paid or denied medical claims based upon established claims processing criteria.
Customer Service Representative/Help Desk Support Specialist
Blue Cross Blue Shield Of Michigan
02.2023 - 03.2023
- Streamlined help desk operations for increased efficiency and improved response times.
- Walked user through series of steps to determine problem and implement likely solution.
- Responded to inquiries by phone and email.
- Assisted internal CSRs with questions on claims, benefits and billing issues.
- Assisted Agents with billing, claims, and benefit questions.
- Encouraged internal representatives for jobs well done.
Interim Analyst (ODLM)
Blue Cross Blue Shield Of Michigan
10.2022 - 02.2023
- Collected, arranged, and input information into database system.
- Gathered, organized and input information into digital database.
- Assisted in creating webpages for internal help system used by representative.
- Created OBN's from employer health insurance choice in benefits to assist representatives in quoting benefits to members.
- Assisted in daily operations surrounding employee benefits packages.
Customer Service Representative 3/Customer Service Representative/Help Desk Support Specialist
Blue Cross Blue Shield Of Michigan
04.2022 - 10.2022
- Streamlined help desk operations for increased efficiency and improved response times.
- Walked user through series of steps to determine problem and implement likely solution.
- Responded to inquiries by phone and email.
- Assisted internal CSRs with questions on claims, benefits and billing issues.
- Assisted Agents with billing, claims, and benefit questions.
- Encouraged internal representatives for jobs well done.
Provider Service Representative 2
Blue Cross Blue Shield Of Michigan
01.2020 - 04.2022
- Assisted providers with claims, billing, and benefit questions.
- Assisted in reprocessing claims based on member benefits.
- Enhanced customer satisfaction by swiftly addressing and resolving service-related issues.
- Handled provider inquiries and suggestions courteously and professionally.
- Answered provider telephone calls promptly to avoid on-hold wait times.
- Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
- Educated providers about billing, payment processing and support policies and procedures.
- Assisted with preauthorizations and provider appeals.
Customer Service Representative 2
Blue Cross Blue Shield Of Michigan
07.2016 - 01.2020
- Handled customer inquiries and suggestions courteously and professionally.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Assisted with claim questions and benefits ensuring members understood their benefits and claims.
Licensed Producer/Customer Service Advocate
Farmers Insurance
02.2016 - 07.2016
- Assisted with daily organizational information as it pertained to members and their personal lines insurance products.
- Assisted with questions and claim questions.
Education
Masters of Philosophy - Developmental Psychology
Walden University
Minneapolis, MN 05.2001 -
MBA - Strategic Management
Davenport University
Grand Rapids, MI 05.2001 -
BBA - Health Services Administration
Davenport University
Grand Rapids, MI 05.2001 -
Skills
Claims analysis
Regulatory knowledge
Claims Processing
Policy Interpretation
HIPAA Compliance
Medical Coding
Insurance Law Understanding
Insurance claims processing
Medical terms and procedure knowledge
Thorough claims reviews
Insurance Claims
HIPAA
Computer Skills
Problem-Solving
Claims adjustment
Timeline
Health Insurance Claims Adjudicator
Blue Care Network Of Michigan
03.2023 - Current
Customer Service Representative/Help Desk Support Specialist
Blue Cross Blue Shield Of Michigan
02.2023 - 03.2023
Interim Analyst (ODLM)
Blue Cross Blue Shield Of Michigan
10.2022 - 02.2023
Customer Service Representative 3/Customer Service Representative/Help Desk Support Specialist
Blue Cross Blue Shield Of Michigan
04.2022 - 10.2022
Provider Service Representative 2
Blue Cross Blue Shield Of Michigan
01.2020 - 04.2022
Customer Service Representative 2
Blue Cross Blue Shield Of Michigan
07.2016 - 01.2020
Licensed Producer/Customer Service Advocate
Farmers Insurance
02.2016 - 07.2016
Masters of Philosophy - Developmental Psychology
Walden University
05.2001 -
MBA - Strategic Management
Davenport University
05.2001 -
BBA - Health Services Administration
Davenport University
05.2001 -