Erika Runnels
Abilene,TX
Summary
Adept at claims analysis and fostering teamwork, I enhanced operations at Blue Cross and Blue Shield by implementing effective claim document systems and settling complex claims efficiently. My background also includes excelling in customer service and problem-solving, significantly improving departmental organization and customer satisfaction. Experienced with managing and resolving insurance claims efficiently. Utilizes analytical skills and industry knowledge to assess and process claims accurately. Track record of maintaining high standards in customer service and problem resolution.
Overview
12
12
years of professional experience
Work History
Claims Technician
Blue Cross and Blue Shield
03.2022 - 10.2024
- Assisted with training new employees, sharing knowledge and expertise to ensure smooth onboarding process.
- Compiled detailed reports on claim trends for management review, leading to data-driven improvements in operations.
- Investigated claims for accuracy, verifying proper documentation to prevent fraud.
- Improved departmental organization through the implementation of an effective filing system for claim documents.
- Checked documentation for accuracy and validity on updated systems.
- Enhanced customer satisfaction by efficiently managing insurance claims processes and providing timely resolutions.
- Evaluated and settled complex insurance claims in strict timeframes.
- Maintained compliance with industry regulations and standards by staying current on relevant laws, policies, and best practices for handling insurance claims.
- Followed up with customers on unresolved issues.
DS II
Hills Resource
10.2016 - 02.2022
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Excellent communication skills, both verbal and written.
- Worked well in a team setting, providing support and guidance.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Managed time efficiently in order to complete all tasks within deadlines.
- Worked flexible hours across night, weekend, and holiday shifts.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
Sales Associate
Sephora
10.2018 - 01.2019
- Accurately processed POS transactions, returning coin, currency, payment cards, and receipts to customers.
Cashier
Walmart
08.2012 - 11.2014
- Operated cash register for cash, check, and credit card transactions with excellent accuracy levels.
Skills
- Claims analysis
- Claims Processing
- Microsoft Office
- Liability Determination
- Insurance knowledge
- Claims Investigation
- Teamwork and Collaboration
- Customer Service
- Problem-Solving
- Time Management
- Attention to Detail
- Multitasking
- Organizing and Prioritizing Work
- Excellent Communication
- Critical Thinking
- Organizational Skills
- Adaptability and Flexibility
- Decision-Making
- Teamwork skills
- Computer Proficiency
- Documentation skills
- Data Entry
- Claims adjustment
- Medical Terminology
- Policy Renewals
- Insurance Coverage Verification
- Written Communication
- Paperwork Processing
- Understanding of medical terms
- Denied claims identification
Timeline
Claims Technician
Blue Cross and Blue Shield
03.2022 - 10.2024
Sales Associate
Sephora
10.2018 - 01.2019
DS II
Hills Resource
10.2016 - 02.2022
Cashier
Walmart
08.2012 - 11.2014
Similar Profiles
Ashly DavisAshly Davis
Client Services Representative at Florida Blue (Blue Cross and Blue Shield of Florida)Client Services Representative at Florida Blue (Blue Cross and Blue Shield of Florida)
Katia GaudichetKatia Gaudichet
Administrative Assistant at Florida Blue - Blue Cross Blue Shield Of FloridaAdministrative Assistant at Florida Blue - Blue Cross Blue Shield Of Florida
Andrew LetrickAndrew Letrick
Provider Services Representative at Blue Cross and Blue Shield of NebraskaProvider Services Representative at Blue Cross and Blue Shield of Nebraska
Abigail Ferguson, LCSWAbigail Ferguson, LCSW
Behavioral Health Care Coordinator in Utilization Management for Government Programs at Blue Cross and Blue Shield Illinois/HCSCBehavioral Health Care Coordinator in Utilization Management for Government Programs at Blue Cross and Blue Shield Illinois/HCSC
Mihee KotatsuMihee Kotatsu
General Ledger and Accounts Payable Specialist at Godiva Japan, Inc.General Ledger and Accounts Payable Specialist at Godiva Japan, Inc.