Falon Palmer
Bridgeport,CT
Summary
Obtain a challenging service position with a progressive company that will benefit the employer and potentially offer promotion opportunities. I am customer and co-worker friendly. Fast learner with ability to work independently as well as work in a team atmosphere.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Account Assistant IV
Yale University
04.2022 - Current
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Managed workload and priorities to meet claims processing meet deadlines.
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Followed up with customers on unresolved issues.
- Assisted with answering providers and members calls inquiring claim status.
- Responded to customer inquiries, providing detailed explanations of insurance policies and claims processes via email.
- Manually keyed in claims based of paper images submitted.
Patient Financial Access Rep
Bridgeport Hospital
04.2020 - Current
- Managed registration process efficiently, ensuring smooth check-in experiences for attendees.
- Assisted customers with inquiries, providing clear instructions on registration procedures and requirements.
- Verify and update patient's demographics and insurance
- Collect copays due based insurance policy
- Assist clinical staff with collecting patient's urine specimen
Process Specialist
Cognizant Technology Solutions
02.2020 - 04.2022
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Verified patient insurance coverage and benefits for medical claims.
- Managed large volume of medical claims on daily basis.
- Monitored and updated claims status in claims processing system.
- Paid or denied medical claims based upon established claims processing criteria.
Direct Support Professional
Kennedy Center
03.2019 - 02.2020
- Assisted clients with daily living needs to maintain self-esteem and general wellness.
- Maintained detailed documentation of client progress, daily activities, incidents, and relevant observations to ensure continuity of care across team members.
- Cleaned house, ran errands, managed laundry, and completed weekly grocery shopping.
- Managed medications for clients, ensuring proper dosages were taken on schedule and any side effects were promptly reported to healthcare professionals.
- Monitored client vital signs, administered medications, and tracked behaviors to keep healthcare supervisor well-informed.
Pend/Adjustment Specialist
ConnectiCare, Inc.
09.2013 - 02.2020
- Identified trends in claim denials and developed strategies to address them, resulting in fewer rejected claims.
- Assisted management with process improvement initiatives that led to increased departmental efficiency and accuracy levels.
- Managed a high volume of daily claims while consistently meeting deadlines and maintaining quality standards.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Processed high volumes of medical claims accurately and efficiently under tight deadlines, ensuring prompt payment for services rendered.
- Processed appeals based on documentation submitted by providers.
- Responded back to customer services inquiries about claim status.
- Assisted in updating documentation.
- Processed high dollar and specialty claims.
Clinical Receptionist
Ultimate Staffing
06.2013 - 09.2013
- Company Overview: Yale University (Smillow Center)
- Yale University (Smillow Center)
- Supported efficient office workflow through prompt distribution of incoming faxes, mail, and lab results.
- Streamlined appointment scheduling processes for improved patient satisfaction and reduced wait times.
- Managed confidential medical documentation according to clinic policy while maintaining strict adherence to privacy guidelines.
- Expedited check-in process by proactively preparing required forms and materials ahead of time.
- Facilitated communication between patients, providers, and insurance companies to resolve billing issues promptly.
Patient Account Service Representative
Ultimate Staffing
12.2012 - 06.2013
- Assisted in updating patient's demographics and insurance
- Answered calls to direct patient's to the correct departments.
- Answered benefits and eligibility questions.
Direct Marketing Inbound Associate
Connecticare
09.2012 - 12.2012
- Answered phone with friendly greeting to create positive inbound calling experience for customers.
- Streamlined application processes for potential clients, resulting in improved client acquisition rates.
- Identified cross-selling opportunities within existing client base by reviewing plan usage data and identifying areas where additional coverage may be beneficial.
Claims Processor
Health Net, Inc
01.2008 - 08.2010
- Managed high volume of claims, prioritizing tasks to meet deadlines without sacrificing quality.
- Reviewed and analyzed claims to ensure accuracy, completeness, and compliance with company policies.
- Managed workload and priorities to meet claims processing meet deadlines.
- Collaborated with cross-functional teams to resolve complex claims issues efficiently and effectively.
- Utilized specialized software to process incoming claims, enter data and generate reports.
- Evaluated accuracy and quality of data entered into agency management system.
- Utilized excellent analytical and problem-solving skills to quickly and accurately assess insurance claims.
Operator
Kelly Services
01.2007 - 01.2008
- Enhanced customer satisfaction by efficiently handling incoming calls and addressing inquiries.
- Contributed to a positive work environment by supporting team members in handling difficult calls or resolving complex issues.
- Maintained professionalism and courtesy while managing high call volumes during peak hours.
- Managed distributing pagers to staff within the company
Personal Financial Representative
Washington Mutual
05.2005 - 11.2006
- Managed high-volume cash handling responsibilities while maintaining accuracy and security standards.
- Assisted in training new hires on bank procedures, systems usage, regulatory requirements, ensuring seamless integration into the team environment.
- Opened accounts based on the customer's needs
- Balanced the ATM daily
- Supported team members in daily tasks, fostering a collaborative work environment.
Customer Service Representative
Trilegiant
05.2004 - 12.2004
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Responded to customer requests for products, services, and company information.
- Assisted customers in navigating company website and placing online orders, improving overall user experience.
Cashier
Shaw's
03.2003 - 01.2004
- Greeted customers entering store and responded promptly to customer needs.
- Operated cash register for cash, check, and credit card transactions with excellent accuracy levels.
- Maintained a balanced cash drawer, ensuring accurate accounting at the end of each shift.
- Restocked and organized merchandise in front lanes.
- Counted money in cash drawers at beginning and end of shifts to maintain accuracy.
- Assisted customers with inquiries and provided exceptional service, resulting in positive feedback from shoppers.
Student Financial Aid Assistant
Morgan State University
09.2003 - 12.2003
- Performed wide-ranging administrative, financial and service-related functions.
- Increased student satisfaction by providing clear and concise information on available financial aid options.
- Assisted students with completing complex financial aid forms, ensuring timely submission and accurate data entry.
Education
High School Diploma -
Kolbe Cathedral High School
Bridgeport, CTGeneral Studies
Housatonic Community College
Bridgeport, CT06.2003
General Studies
Morgan State University
Baltimore, MD12.2006
Skills
- Reliable
- Energetic
- Adaptable
- Friendly
- Fast Learner
- Clear Written and Verbal Communicator
- Flexible
- Focused
- Dependable
- Time management
Certification
- Certified Medication Technician
- CPR Certified, 03/19/19
Timeline
Account Assistant IV
Yale University
04.2022 - Current
Patient Financial Access Rep
Bridgeport Hospital
04.2020 - Current
Process Specialist
Cognizant Technology Solutions
02.2020 - 04.2022
Direct Support Professional
Kennedy Center
03.2019 - 02.2020
Pend/Adjustment Specialist
ConnectiCare, Inc.
09.2013 - 02.2020
Clinical Receptionist
Ultimate Staffing
06.2013 - 09.2013
Patient Account Service Representative
Ultimate Staffing
12.2012 - 06.2013
Direct Marketing Inbound Associate
Connecticare
09.2012 - 12.2012
Claims Processor
Health Net, Inc
01.2008 - 08.2010
Operator
Kelly Services
01.2007 - 01.2008
Personal Financial Representative
Washington Mutual
05.2005 - 11.2006
Customer Service Representative
Trilegiant
05.2004 - 12.2004
Student Financial Aid Assistant
Morgan State University
09.2003 - 12.2003
Cashier
Shaw's
03.2003 - 01.2004
General Studies
Housatonic Community College
General Studies
Morgan State University
High School Diploma -
Kolbe Cathedral High School
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