Erin Craver
Pampa,TX
Summary
Enthusiastic entry level Claim Benefit Specialist with 2 years of experience. Strong understanding of complex healthcare billing principles, procedures, and processes. Proven ability to research and implement solutions to complex billing issues. Seeking to advance career as a Claim Benefit Specialist at CVS Health.
Overview
8
8
years of professional experience
Work History
Claims Technician
Blue Cross Blue Shield of Texas- HCSC
Marshall, TX
09.2020 - Current
- Identify discrepancies in 95 % of medical claims while independently investigating 50 claims per day.
- Utilize medical terminology and HIPAA knowledge to coordinate insurance benefits.
- Analyze and approve routine claims that cannot be promptly adjudicated by system.
- Assist in adjudication of claims by following medical necessity guidelines, verifying coverage, and applying all cost-containment measures.
- Collaborate and communicate with teammates by chatting with them or sending emails to solve problems and reduce errors by 10%.
- Maintain 100 % financial accuracy for year.
Claims Technician
Kelly Services
Marshall, TX
03.2020 - 09.2020
- Verified client information and followed up on potentially fraudulent claims
- Reviewed and adjudicated routine claims in accordance with claim processing guidelines maintaining 98%accuracy
- Access provider coding information to report services and verify correctness
- Embraced transition from production environment to working remotely independently
- Processed complex claims and routed to Senior Claim Benefits Specialist for action, leading to faster claim resolution and improved customer satisfaction
Customer Service Representative
Teleperformance
Shreveport, LA
12.2019 - 03.2020
- Exceeded expectations of 40 calls per shift by more than 15 per shift with due diligence resulting in customer satisfaction rating of 98% (highest team score)
- Contributed to company achieving and holding industry‑leading customer service ratings
- Resolved concerns with products or services to help with retention and drive sales
Administrative Assistant
Andreas Angels Two
Marshall, TX
10.2016 - 03.2019
- Updated and organized physical and digital files to maintain compliant documentation, reducing risk of non-compliance
- Led 13 team members in providing support and guidance to 50 children, reducing disciplinary incidents by 45%, and increasing student enrollment by 10%
Tobacco Associate
Tobacco Junction
Longview, TX
11.2014 - 10.2016
- Achieved being only employee able to open and close all 5 separate locations, helping customers locate and purchase items, increasing sales by 25%
- Trained and mentored new cashiers to maximize performance with skilled, efficient, and knowledgeable team members
Store Manager
CEFCO Convenience Stores
Longview, TX
09.2013 - 11.2014
- Managed team of 15 with minimal supervision and limited resources, scheduling, budgeting, and inventory control, leading to greater efficiency, improved productivity, and cost savings
- Collaborated with other stores in district to increase donations for charity by 35%, without negatively impacting store traffic, while increasing customer satisfaction
Education
High School Diploma -
Ore City High School
Ore City, TX05.2002
Skills
- Health Insurance
- Complex Claims
- Eligibility verification
- Medicare
- UB
- ICD-9
- CPT Coding
- Medical Claims Processing
- Claim Adjudication
- Coordination of Benefits
- HIPPA
- Medical Terminology
- CMS
- ICD-10
- Procedure Codes
Websites
Timeline
Claims Technician
Blue Cross Blue Shield of Texas- HCSC
09.2020 - Current
Claims Technician
Kelly Services
03.2020 - 09.2020
Customer Service Representative
Teleperformance
12.2019 - 03.2020
Administrative Assistant
Andreas Angels Two
10.2016 - 03.2019
Tobacco Associate
Tobacco Junction
11.2014 - 10.2016
Store Manager
CEFCO Convenience Stores
09.2013 - 11.2014
High School Diploma -
Ore City High School
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