Keiara Robinson
Grand Prairie
Summary
Experienced professional with a strong background in customer interactions and service solutions. Skilled at resolving conflicts, communicating effectively,entering and processing claims, and solving problems to ensure customersatisfaction and loyalty. Excels as a team collaborator, easily adapting to changing needs while remaining focused on achieving results through efficient and empathetic service. Reputation for reliability and a proactive approach consistently allows for meeting both customer and organizational goals.
Overview
10
10
years of professional experience
Work History
Customer Service Representative Sr
United Health Group
09.2023 - 02.2026
- Initiate prior authorization requests
- Validate insurance types (Medicaid, Medicare, Commercial, etc.)
- Access multiple Optum resources to check prior authorization status and benefits
- Problem-solve with decisiveness and urgency, escalating to operations partners, team leads, management, and other stakeholders as needed
- Ensure patients and providers are supported by following escalations through to completion
- Identified and resolved claim denials or rejections through investigation andcommunication with payers.
- Maintain strict confidentiality and adhere to all privacy and security regulations when handling sensitive information
- Reviewed and analyzed medical claims for accuracy, completeness, and compliance with insurance policies and regulations.
- Utilized coding systems such as ICD-9, ICD-10, CPT (Current ProceduralTerminology), and DRG (Diagnosis-Related Group) to assign appropriate codesto diagnoses and procedures.
- Conducted utilization management support by reviewing prior authorization requests for medical necessity, verifying eligibility and benefits, and coordinating with providers and internal teams to ensure timely, compliant care decisions with United Healthcare
Student Loan Collector
Navient
11.2017 - 12.2019
- Communicated with borrowers to ensure repayment or arrange payment plans
- Assisted with loan consolidation and rehabilitation
- Ensured compliance with Federal Regulations
- Improved efficiency by quickly learning new skills
Member Services Representative
Teleperformance USA
06.2016 - 11.2017
- Assisted members with health plan inquiries
- Fostered business relationships through prompt service
- Delivered excellent customer service
- Handled over 100 calls per shift, addressing member concerns
Education
High School Diploma -
Uplift Hampton Preparatory High School
Dallas, TXSkills
- Customer Service and Assistance
- Account Management
- Microsoft Office
- Salesforce
- CRM Software
- Active Listening
- Analytical and Problem-Solving Skills
- Inbound and Outbound Calling
- Customer Data Confidentiality
- Accounts Payable and Receivable
- Call Documentation
- Data Entry Software
- Claim Processing
Timeline
Customer Service Representative Sr
United Health Group
09.2023 - 02.2026
Student Loan Collector
Navient
11.2017 - 12.2019
Member Services Representative
Teleperformance USA
06.2016 - 11.2017
High School Diploma -
Uplift Hampton Preparatory High School