Ericka Moore
Orlando,FL
Summary
Accomplished Reimbursement Specialist with a proven track record at CareMetx, adept in Medicaid knowledge and delivering exceptional customer support. Excelled in guiding staff through complex insurance verifications and claims processing, significantly reducing claim denials. Renowned for a professional phone voice and a customer-centric approach, consistently achieving positive outcomes.
Overview
17
17
years of professional experience
Work History
Reimbursement Specialist
CareMetx
10.2022 - Current
- Guided office staff on how to effectively complete prior authorization forms and appeals documentation to achieve positive results.
- Prevented delays and claim denials by correcting information prior to submission.
- Delivered timely information to insurance representatives to resolve common and complex issues.
- Gathered information, assessed and fulfilled callers' needs and educated on important policies and procedures.
- Completed intake assessment forms and filed clients' charts.
- Answered phone calls and provided new clients with required paperwork to initiate service.
Customer Service Representative
Walmart Specialty Pharmacy
10.2017 - 09.2022
- Responded to customer requests, offering excellent support and tailored recommendations to address needs.
- Educated customers about billing, payment processing and support policies and procedures.
- Identified and resolved discrepancies and errors in customer accounts.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Answered phone with friendly greeting to create positive inbound calling experience for customers.
Case Manager Specialist
Kroger Specialty Pharmacy
12.2007 - 03.2016
- Asked fact-finding questions to determine customer needs and expectations and recommended specific products and solutions.
- Answered phone with friendly greeting to create positive inbound calling experience for customers.
- Responded to inquiries by phone, email and walk-up requests.
- Documented and detailed calls and complaints using call center's CRM database.
- Adhered to company policies and scripts to consistently achieve call-time and quality standards.
- Placed outbound customer service or customer satisfaction calls to follow up on issues.
Education
Diploma - Business Administration
Florida Career College
Orlando, FL05-2022
Certificate - Medical Assistant
Everest College
Orlando, FL05-2012
GED -
Orange Technical College-Mid Florida Campus
Orlando, FL05-1999
Skills
- Professional phone voice
- Customer Needs Assessment
- Customer Support
- HIPAA Compliance
- Policy evaluation
- Commercial insurance
- Microsoft Office
- Insurance Verification
- Claims Processing
- Call Management
- Customer Service
Timeline
Reimbursement Specialist
CareMetx
10.2022 - Current
Customer Service Representative
Walmart Specialty Pharmacy
10.2017 - 09.2022
Case Manager Specialist
Kroger Specialty Pharmacy
12.2007 - 03.2016
Diploma - Business Administration
Florida Career College
Certificate - Medical Assistant
Everest College
GED -
Orange Technical College-Mid Florida Campus
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