KAYLA TARVER
Columbus,GA
Summary
Versatile Customer Service Representative committed to maintaining high customer satisfaction by providing friendly, fast service for all needs. Skillful in researching and resolving billing discrepancies and claims. Disciplined and energetic professional well-versed in medical claim appeal processing, clinical relations and medical billing.
Overview
5
5
years of professional experience
Work History
Provider Relations Representative
RemX Staffing
12.2023 - Current
- Implemented system for tracking provider feedback, allowing for data-driven improvements to internal processes and enhanced satisfaction among network partners.
- Negotiated contracts with providers, securing favorable terms while maintaining strong partnerships within network.
- Greeted and assisted patients with check-in procedures.
- Managed provider relations mailbox by triaging inquiries, facilitating resolution of incoming requests and forwarding requests to appropriate parties.
- Verified patient insurance eligibility and entered patient information into system.
- Brought in 25 new providers to enhance coverage and meet program goals.
Production Worker
TRC Staffing
09.2023 - 11.2023
- Assisted in training new employees on production processes, ensuring seamless integration into team.
- Provided support during equipment maintenance, minimizing downtime and ensuring consistent production output.
- Adjusted machines to increase productivity for runs.
- Calibrated machines to maintain required productivity levels and adherence to quality standards.
- Supported machine operators in setup and operation of production equipment resulting in efficient runs.
Fraud Specialist
U.S. Bank
05.2022 - 10.2022
- Managed on average 75 calls per day submitting and reviewing fraud claims.
- Reviewed reports and individual transactions which appeared suspicious to uncover possible fraudulent activity.
- Analyzed large amounts of data to find patterns of fraud and anomalies.
- Contacted customers directly to notify of fraudulent activity and minimize impacts.
- Collaborated with team members to discuss fraud trends and brainstorm methods to combat this type of crime.
- Gathered evidence, which included recorded and written statements, financial documentation and audio materials for examination.
Medical Customer Service Representative
Anthem Blue Cross BlueShield
10.2021 - 04.2022
- Answered about 50-65 calls per day regarding patient questions and fielded complaints to resolve issues.
- Accessed patient information through various software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations
- Scheduled and confirmed patient appointments with patients and healthcare professionals
- Coordinated with patients and healthcare professionals to meet patient needs
- Documented and managed patient information in computer system
- Referred patients to appropriate professionals and services
- Checked daily doctor schedules and verified insurance
- Scheduled patient appointment and procedures
- Checked claims for errors, corrected issues and mailed out updated documents.
Account Research Specialist
TSYS
11.2018 - 10.2020
- Developed and maintained databases, pulling relevant data
- Obtained data from patient medical records, histories and surveys
- Collected and analyzed data to contribute to manuscripts and publications
- Applied banking knowledge and credit union programs to boost after-market product sales
- Assisted customers with price checks, lifting heavy items and addressing other inquiries
- Displayed strong telephone etiquette, effectively handling difficult calls
- Answered questions and informed customers of current sales and promotions
- Upheld compliance, quality and service standards
- Established accounts for new customers and updated existing accounts with current demographic and order information
- Resolved problems by performing both routine and complex account updates
- Used networking, customer service and interpersonal skills to connect with potential customers and make sales
- Tracked customer desires and dislikes in order to help management understand needs and update offerings.
Education
Bachelor Of Science - Criminal Justice
South University
Savannah, GA12.2027
Skills
- Can type 50 wpm
- Appointment confirmation
- Medical Terminology
- Medical billing
- Office administration
- Customer relations
- Credit card payment processing
- Problem-solving abilities
- Microsoft Office expertise
- Clerical support
- Inbound and Outbound Calling
- Care Plan Recommendations
- Member enrollment
Timeline
Provider Relations Representative
RemX Staffing
12.2023 - Current
Production Worker
TRC Staffing
09.2023 - 11.2023
Fraud Specialist
U.S. Bank
05.2022 - 10.2022
Medical Customer Service Representative
Anthem Blue Cross BlueShield
10.2021 - 04.2022
Account Research Specialist
TSYS
11.2018 - 10.2020
Bachelor Of Science - Criminal Justice
South University
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