Committed to ensuring customer satisfaction by providing exceptional service and unmatched support. Proficient in utilizing customer service best practices and adept at exploring different solutions to address customer needs effectively.
Overview
4
4
years of professional experience
Work History
Healthcare Customer Service Representative/Claims Representative
Cigna
Remote
12.2022 - Current
Accurately process a high volume of insurance claims daily, ensuring each claim complies with Cigna’s policies and procedures.
Review claim submissions for completeness, accuracy, and compliance with regulatory standards. Enter and update claim information in Cigna’s claims processing system.
Monitor the status of claims from submission through resolution, ensuring timely processing. Prioritize claims based on urgency and ensure all claims are handled within designated timeframes.
Manage the workflow to meet daily, weekly, and monthly claims processing targets. Document all actions taken on claims, including communications, corrections, and decisions.
Healthcare Customer Service Representative/Legal Intake Specialist
CareCentrix
Remote
10.2020 - 12.2022
Collecting and verifying patient information. Entering patient data into electronic health records (EHR) systems. Ensuring all necessary paperwork is completed and filed.
Scheduling patient appointments. Coordinating with healthcare providers to ensure availability. Managing appointment reminders and follow-ups.
Answering phone calls and addressing patient inquiries. Handling patient complaints and resolving issues or escalating them as necessary.
Providing patients with pre-appointment instructions and post-appointment care guidelines. Assisting patients with billing questions. Processing payments and setting up payment plans. Handling insurance claims and follow-up on unpaid claims
Education
Houston Community College
Houston, TX
Skills
Insurance Verification
Medical terminology knowledge
Appointment Scheduling
Call center experience
Claims Processing
Data Entry
Remote Operations
Chat Support
Email Support
HIPAA Compliance
Customer Service
Problem-Solving
Eligibility Determination
Inbound Call Management
Inbound/OutBound Call Center
Call Management
Customer Relationship Management (CRM)
De-Escalation Techniques
Exceeding Customer Expectations
Benefit Verifications
Insurance Coverage Verification
Prior authorization processing
Timeline
Healthcare Customer Service Representative/Claims Representative
Cigna
12.2022 - Current
Healthcare Customer Service Representative/Legal Intake Specialist
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