Joyce Council
Tampa,FL
Summary
Analytical problem-solver with excellent communication skills. Effective at interviewing claimants, compiling records and documenting findings. Well-versed in customer service, data entry, billing processing & insurance policies, practices and standards.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Banking Specialist
USAA
04.2023 - Current
- Successfully resolved complex customer complaints, demonstrating empathy and professionalism throughout the process.
- Maintained excellent client relations, resulting in increased referrals and repeat business.
- Managed risk effectively by conducting thorough credit assessments and adhering to established lending guidelines.
- Executed wire transfers, stop payments and account transfers.
- Received mortgage, loan or public utility bill payments, verifying payment dates and amounts due.
- Performed account maintenance by closing out accounts and changing customer addresses.
- Processed wide variety of retail banking transactions for personal and commercial customers.
Claims Representative
Maximus Federal Services
11.2018 - 04.2023
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Coordinated with contracting department to resolve payer issues.
- Analyzed and addressed escalated claims to resolve issues quickly.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
- Worked productively in fast-moving work environment to process large volumes of claims.
Billing & Data Entry Processor
Sunrise Senior Living
05.2017 - 09.2019
- Maintained contact with customers to research billing questions and furnish copies of support documentation.
- Negotiated payment arrangements with customers to establish timely receipt of payments.
- Identified, researched, and resolved billing variances to maintain system accuracy and currency.
- Accepted customer credit card payments over phone, set up billing arrangements and processed recurring payments to keep accounts current.
- Conducted audits of existing data entry processes.
- Analyzed current data records to provide detailed reports.
- Compared transcribed data with source document to detect and correct errors.
Insurance Verification Coordinator
Tampa General Hospital
12.2016 - 11.2017
- Maintained patient confidentiality and safeguarded medical records to avoid information breaches.
- Contacted insurance companies to obtain prior authorization for medical procedures and medications.
- Researched denied claims and contacted insurance companies to resolve these issues.
- Provided prior authorization support for physicians, healthcare providers and patients in accordance with payer guidelines.
- Tracked referral submission during facilitation of prior authorization issuance.
- Maintained compliance with HIPAA regulations while handling sensitive patient information during the verification process.
- Collaborated with healthcare providers to ensure timely submission of required documentation for patient treatment approvals.
Financial Services Representative
T-Mobile
06.2015 - 10.2017
- Discussed financial options with clients and provided informed suggestions.
- Monitored customer accounts to identify and rectify billing issues.
- Identified payment trends and adjusted billing processes accordingly to retain customers.
- Handled account payments and provided information regarding outstanding balances.
- Responded to customer concerns and questions on daily basis.
- Provided excellent customer service, resolving issues quickly and maintaining long-term client relationships.
- Assisted clients in navigating complex financial situations, offering solutions that met their unique needs.
Education
High School Diploma -
Thomas Jefferson High School
Skills
- Customer Service Excellence
- Customer Data Confidentiality
- Insurance Knowledge
- Customer Retention Strategies
- Needs Assessment
- Data Entry and Quality Assurance
- Client Rapport-Building
- Claims Processing
- Customer Account Management
- Efficient and Detail-Oriented
- Call Documentation
- Financial Management
- Account Reconciliation
- Billing Dispute Resolution
- Customer Satisfaction
- Appeals &Denials
- Inbound Calls
- Claims Review
- Correspondence Writing
- Issue and Complaint Resolution
- Critical Thinking
- Data Accuracy
- Documentation Research
- Settlement Determinations
- Electronic Authorization Processing
- Payor Procedures
- CPT Coding
- Team-Oriented and Cooperative
Certification
CNA
CPR Certification
References
Available Upon Request
Languages
English
Full Professional
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Banking Specialist
USAA
04.2023 - Current
Claims Representative
Maximus Federal Services
11.2018 - 04.2023
Billing & Data Entry Processor
Sunrise Senior Living
05.2017 - 09.2019
Insurance Verification Coordinator
Tampa General Hospital
12.2016 - 11.2017
Financial Services Representative
T-Mobile
06.2015 - 10.2017
High School Diploma -
Thomas Jefferson High School