Gloria J. Young
Verona,PA
Summary
Results-driven benefits specialist with expertise in navigating complex verification processes. Strong analytical skills and in-depth knowledge of insurance protocols ensure accurate and timely benefit resolutions. Known for effective collaboration, adaptability, and steadfast commitment to achieving team goals. Highly reliable, with focus on precision and compliance in all tasks.
Overview
26
26
years of professional experience
Work History
Benefits Verification Specialist
CVS Specialty Pharmacy
10.2015 - 07.2025
- Optimized the use of electronic claims submission systems to expedite claim processing times.
- Ensured timely reimbursements by proactively identifying potential issues that could delay claim processing and addressing them before submission.
- Assisted clients with resolving complex benefits issues, improving overall customer satisfaction.
- Collaborated with healthcare providers to ensure accurate billing and benefit coverage information.
- Enhanced claim processing efficiency by reviewing and verifying insurance benefits information.
H.R. Substitute Administrative Secretary
Wilkinsburg School District
03.2012 - 08.2013
- Support human resources processes by scheduling appointments, maintaining records and information.
- Created new hiring packets; verified paper work including FBI fingerprint, Criminal and I-9 information.
- Maintain employee confidence and protect operations by keeping human resource information confidential.
Pre-Arrival Representative
UPMC
01.2011 - 01.2012
- Obtained pre-certification when required for scheduled services prior to admission.
- Obtained and communicate estimates for procedures as required.
- Verified insurance benefits with insurance company or other agency.
- Provided financial education to patient and family on insurance matters.
Accounts Receivable Billing Specialist
Med3000
01.2009 - 01.2010
- Processed collection accounts in a timely manner.
- Identified and corrected billing errors on patients’ accounts.
- Completed and issued patient and insurance refunds.
- Reviewed insurance payments to ensure payments are made according to fee schedules, as well as resolved problems with bad debits, overpayments and bill adjustments.
Quality Assurance Fax Clerk
UPMC
01.2008 - 01.2009
- Responsible for interacting with hospitals and physicians.
- Gained medical information and test results of patients.
- Answered incoming phone calls and handled documentation daily and weekly.
- Faxed authorizations.
Associate Technical Claims Specialist
Concentra Integrated Services
01.2000 - 01.2007
- Accurate reprising of medical, hospital, dental, vision and specialist claims for various states.
- Responsible for answering provider inquiries (written and phone).
- Cross-trained on all departmental duties to increase team efficiencies and eliminate down time.
Education
Bachelors of Professional Studies Human Resources - Human Resources
06-2019
Business Health and Administration
01-2014
Business Skilled Centered
01.1973
Skills
- Certified in CPT and ICD-9 medical terminology
- Independent and collaborative worker
- Effective verbal communication
- Customer and client relations
- Adaptability to change
- Reliability
- Quick learner
Timeline
Benefits Verification Specialist - CVS Specialty Pharmacy
10.2015 - 07.2025
H.R. Substitute Administrative Secretary - Wilkinsburg School District
03.2012 - 08.2013
Pre-Arrival Representative - UPMC
01.2011 - 01.2012
Accounts Receivable Billing Specialist - Med3000
01.2009 - 01.2010
Quality Assurance Fax Clerk - UPMC
01.2008 - 01.2009
Associate Technical Claims Specialist - Concentra Integrated Services
01.2000 - 01.2007
Westinghouse Jr. & Sr. - , Business Skilled Centered
Geneva College - Bachelors of Professional Studies Human Resources, Human Resources
University of Phoenix - , Business Health and Administration
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