Geralyn Benge
Johnson City,TN
Summary
Proven leader with top-notch skills in investigations management, research and analytical problem solving. Proficient in applicable policy guidelines, coverage limitations and related liabilities. Adept at handling tough calls for junior team members, as well as assisting management with keeping the department running smoothly. Hardworking professional experienced in customer service management and quality assurance. Demonstrated success in handling complicated policy issues with efficiency and accuracy. Bringing 15years of related account resolution experience. Expert in resolving account, service and claims issues with speed and accuracy. In-depth understanding of related standards and procedures. . Accomplished in collecting supporting information, drafting and reporting comprehensive documentation and leading agreements to resolve complex problems. Driven to strictly follow applicable laws and ethical procedures for all cases.
Overview
14
14
years of professional experience
Work History
Senior Resolution Specialist
CVS HEALTH CORPORATION
05.2022 - Current
- Developed training programs for new hires to ensure thorough understanding of company policies and procedures.
- Improved customer satisfaction by efficiently resolving complex issues and providing timely solutions.
- Managed a team of junior resolution specialists, providing guidance and support to improve their skills and performance.
- Team Lead provided support for supervisor and held mini workshops and coached the discrepancies with team members
Customer Service Representative
CVS HEALTH CORPORATION
07.2019 - Current
- Handled customer inquiries and suggestions courteously and professionally.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled new members understand their plan policy
Insurance Verification Specialist
Covance
02.2015 - 05.2019
- Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Updated patient records with accurate, current insurance policy information.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Improved communication between medical staff and patients by explaining insurance benefits and financial responsibilities.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Collaborated with team members to resolve discrepancies in insurance verification, ensuring proper billing practices.
- Increased patient satisfaction by promptly addressing concerns regarding insurance coverage or billing issues.
- Assisted patients with understanding personalized insurance coverage and benefits.
- Enhanced claim processing efficiency by verifying insurance coverage and obtaining pre-authorizations for procedures.
- Demonstrated a high level of professionalism and attention to detail in all aspects of insurance verification specialist role, consistently exceeding performance expectations.
- Established and maintained relationships with insurance providers for productive communications.
- Achieved insurance pre-authorizations to enable timely patient procedures.
- Developed strong relationships with insurance representatives, facilitating smooth communication channels for resolving inquiries or disputes.
- Expedited patient registration process by efficiently validating eligibility for various insurance plans.
- Reduced errors in billing by accurately maintaining patient records with updated insurance information.
- Optimized productivity within the department by prioritizing tasks according to urgency and importance levels.
Collections Agent
Lincare Healthcare
03.2013 - 02.2015
- Built rapport with customers by demonstrating understanding of their situation while seeking fair resolutions.
- Processed payments and applied to customer balances.
- Maintained high volume of calls and met demands of busy and productive group.
- Negotiated to collect balance in full.
- Achieved successful debt collection results by utilizing negotiation skills and developing customized payment plans.
- Directed day-to-day collections functions.
- Provided exceptional customer service by empathizing with clients'' financial situations while working towards mutually beneficial solutions.
- Achieved performance goals on consistent basis.
Administrative Assistant
Excell Chiropratic
04.2010 - 03.2013
- Answered multi-line phone system, routing calls, delivering messages to staff and greeting visitors.
- Maintained confidentiality of sensitive information by adhering to strict privacy policies and implementing secure filing systems.
- Delivered excellent customer service through prompt responses to client inquiries, addressing concerns effectively, and building strong relationships.
- Ensured accurate record-keeping with diligent data entry and database management for vital company information.
- Promoted a positive work environment through effective communication skills and fostering professional relationships among colleagues.
- Improved document organization with thorough file maintenance, archiving outdated records as necessary for efficient retrieval when needed.
- Received and sorted incoming mail and packages to record, dispatch, or distribute to correct recipient.
- Coordinated office supply inventory management, proactively ordering necessary items before depletion to avoid workflow disruptions.
- Scheduled office meetings and client appointments for staff teams.
- Created and maintained databases to track and record customer data.
- Executed record filing system to improve document organization and management.
- Restocked supplies and placed purchase orders to maintain adequate stock levels.
- Supported executive staff through scheduling meetings, coordinating travel arrangements, and preparing crucial documents.
- Assisted with human resources tasks such as updating employee files or submitting time-off requests per company policy guidelines.
- Assisted in onboarding new employees, providing training materials, and coordinating orientation schedules to ensure a smooth integration into the team.
- Coordinated and scheduled meetings and conference calls to optimize scheduling of senior staff.
- Enhanced office efficiency by streamlining administrative processes and implementing organizational systems.
Education
No Degree - Billing And Coding
Med Tech College - Indianapolis
Indianapolis, INCertificate - Biling
Sanford Brown
Indianapolis, IN04.2010
Skills
- Team Member Training
- Quality assurance expertise
- Assist with Coaching
- Investigation skills
- De-Escalation Techniques
- Policy Interpretation
- Account Updates
- Meeting facilitation
- Team member coaching
- Escalated calls management
- Knowledge of regulations
- Conflict resolution skills
- Information Collection
- Interviewing abilities
- Deductive Reasoning
- Complaint Handling
Timeline
Senior Resolution Specialist
CVS HEALTH CORPORATION
05.2022 - Current
Customer Service Representative
CVS HEALTH CORPORATION
07.2019 - Current
Insurance Verification Specialist
Covance
02.2015 - 05.2019
Collections Agent
Lincare Healthcare
03.2013 - 02.2015
Administrative Assistant
Excell Chiropratic
04.2010 - 03.2013
No Degree - Billing And Coding
Med Tech College - Indianapolis
Certificate - Biling
Sanford Brown
Similar Profiles
Kerry MullenKerry Mullen
Retail Staff Pharmacist at CVS HEALTH CORPORATIONRetail Staff Pharmacist at CVS HEALTH CORPORATION
Sharon KubiakSharon Kubiak
Supervisor at CVS HEALTH CORPORATIONSupervisor at CVS HEALTH CORPORATION
Eric WeathingtonEric Weathington
Production Worker at CVS HEALTH CORPORATIONProduction Worker at CVS HEALTH CORPORATION
Aalyia CastleAalyia Castle
Customer Service Advocate at CVS HEALTH CORPORATIONCustomer Service Advocate at CVS HEALTH CORPORATION
Hannah BurnetteHannah Burnette
Doughnut Decorator at Krispy KremeDoughnut Decorator at Krispy Kreme