EVELYN GARDENHIRE
Ibex
Anna,TX
8
years of professional experience
Healthcare and customer service professional with experience inpatient support, insurance verification, reimbursement, claims resolution, and high-volume customer service. Skilled in accurate documentation, benefits verification, billing support, problem resolution, and cross-functional communication. Known for dependable service, attention to detail, HIPAA-conscious handling of information, and compassionate patient/client support.
Work History
Remote Customer Service Representative
3 Years 6 Months- Resolved inbound customer inquiries involving billing, copayments, coverage, and account issues.
- Assisted with insurance claim processing, follow-up, and issue resolution.
- Collected copayments using approved telephone and secure online payment systems.
- Verified insurance coverage, eligibility, and benefits prior to service.
- Managed high-volume call queues while maintaining accurate documentation in CRM systems.
- Tracked case details, updates, and follow-through to support timely resolution.
Reimbursement Specialist
1 Year 7 Months- Resolved claim denials by researching payer requirements and correcting billing discrepancies.
- Coordinated prior authorization requests for renal services to support timely treatment approvals.
- Verified insurance eligibility and benefits for accurate reimbursement processing.
- Reviewed patient accounts for unpaid balances, missing information, and documentation needs.
- Provided timely solutions to patient/client reimbursement and account-related concerns.
Insurance Claim Service Specialist
2 Years 7 Months- Resolved policyholder inquiries regarding billing, coverage, endorsements, and account changes.
- Coordinated communication among customers, agents, and internal departments to support issue resolution.
- Processed policy changes, renewals, and documentation updates while following compliance standards.
- Reviewed account information and corrected discrepancies to maintain accurate policy records.
Education
High School Diploma
Skills
Claims & Reimbursement
Billing & Account Resolution
HIPAA Compliance
Professional Telephone Communication
Case Follow-Up
Vital Signs & Documentation
Insurance Verification
Prior Authorization Support
Customer Service
Data Entry & CRM Systems
Cross-Functional Coordination
Critical Thinking
Timeline
Remote Customer Service Representative
Ibex
01.2023 - 07.2026Read More
Reimbursement Specialist
Fresenius Kidney Center
06.2021 - 01.2023Read More
Insurance Claim Service Specialist
Mercury Insurance
06.2018 - 01.2021Read More
Bastrop High School
High School Diploma
Read More