Kelley Fleming
Vestavia Hills,AL
Overview
23
23
years of professional experience
Work History
Receiving/Imaging Technician
Blue Cross Blue Shield
Birmingham, AL
02.2020 - Current
- Efficiently sort, prioritize, image, and process premium deposits and refund payments to ensure timely and accurate financial transactions.
- Scan paper applications and electronic payment correspondence for archival and data entry, maintaining organized and accessible digital records.
- Investigate and correct provider addresses for returned mail using RECI, RECE, and RECR systems, reducing mail return rates and improving communication efficiency.
- Conduct in-depth research to retrieve customer contract numbers utilizing MSSP, GEMS, GBC!, Group Access, Navigator, and Mavro platforms, ensuring accurate account identification and resolution.
- Consistently meets and exceeds production-based goals, demonstrating reliability, efficiency, and a strong commitment to operational excellence.
Box Office
Oak Mountain Amphitheater /Coca Cola Amphitheater
Birmingham, AL
04.2019 - Current
- Process ticket sales efficiently while delivering exceptional customer service.
- Respond to customer inquiries with accuracy and professionalism, ensuring a positive experience.
- Managed will call operations, verifying customer identification and ensuring prompt, accurate ticket distribution to maintain efficient service flow.
Insurance Follow-Up Specialist
American Family Care
Birmingham, AL
06.2018 - 12.2018
- Resolved insurance claims by ensuring all assigned cases were accurately billed and followed through to final resolution with the carrier.
- Analyzed and processed insurance denials, identifying appropriate corrective actions and resubmitting rejected claims to facilitate successful adjudication.
- Determined proper assignment of balances owed, either patient balance or insurance balance.
BCRC Specialist I
Cahaba Government Benefit Administrators, LLC
Birmingham, AL
03.2016 - 06.2018
- Reviewed correspondence to verify correct authorization type entry, ensuring compliance and accuracy in data processing.
Finance/Accounting Ops Tech
NGS
Birmingham, AL
07.2015 - 01.2016
- Assigned correct case type and initiate/activate correspondence batches within MCS to process work.
- Processed claim overpayments.
Claims Examiner
Cahaba Government Benefit Administrators, LLC
Birmingham, AL
10.2011 - 06.2015
- Independently, accurately, and timely processed Part A Medicare claims and adjustments.
- Utilized various processing tools to research, initiate, correct and resolve pending claims and/or adjustments.
- Prepared and processed Redetermination case files.
- Identified and provided support documents and medical information to determine payment or denial of services based on CMS regulations and medical policies.
- Received claims through PEGA system and excel spreadsheet.
- Reviewed benefits in HIMR.
- Resolved claims through FISS.
- Assisted Appeals Department when backlogged with appeals indexing and QIC.
Customer Service Associate I
Protective Life Insurance Company
Birmingham, AL
10.2007 - 11.2010
- Ordered files, sorted, identified, and entered incoming work into Policy Tracker System.
- Reviewed reports and assigned to appropriate team members.
- Corrected addresses of returned mail.
- Routed incoming mail to appropriate teams and team members.
- Sent forms to update insureds’ policies.
- Generated bills to insureds.
- Sent copies of annual statements to insureds.
- Added third party designees to policies.
- Sent information regarding policies.
- Verified Social Security numbers.
- Received phone calls from the call center answering insureds questions.
Fast Track Adjuster
Infinity Insurance Company
Birmingham, AL
03.2003 - 10.2007
- Responsible for investigating, negotiating, and settling assigned property damage and minor casualty claims.
- Ensured that claims were processed promptly, equitably, and economically as appropriate to the damage and the provisions of the insurance contract, and in accordance with company policy and applicable law.
Policy Services Specialist
Infinity Insurance Company
Birmingham, AL
03.2003 - 10.2007
- Handled customer service calls to process policy changes, accurately updating information in the internal system.
- Uploaded and maintained new insurance policies in the computer system, ensuring data integrity and timely recordkeeping.
- Reviewed motor vehicle reports for policy renewals.
- Interacted with insurance agents and customers.
Salvage Payment Clerk
Infinity Insurance Company
Birmingham, AL
03.2003 - 10.2007
- Reviewed and processed payments to auction companies.
- Receipted incoming payments to computerized records and completed spreadsheets.
- Researched computer records for information pertaining to accurate completion of claims.
- Prepared and sent correspondence to claimants or made telephone contact.
- Ordered office supplies, sorted, and distributed mail.
Data Entry Clerk
Infinity Insurance Company
Birmingham, AL
03.2003 - 10.2007
- Entered accident reports into system.
Education
Associate of Applied Science Degree - Office Management
Virginia College
Birmingham, AL12.2002
Timeline
Receiving/Imaging Technician
Blue Cross Blue Shield
02.2020 - Current
Box Office
Oak Mountain Amphitheater /Coca Cola Amphitheater
04.2019 - Current
Insurance Follow-Up Specialist
American Family Care
06.2018 - 12.2018
BCRC Specialist I
Cahaba Government Benefit Administrators, LLC
03.2016 - 06.2018
Finance/Accounting Ops Tech
NGS
07.2015 - 01.2016
Claims Examiner
Cahaba Government Benefit Administrators, LLC
10.2011 - 06.2015
Customer Service Associate I
Protective Life Insurance Company
10.2007 - 11.2010
Fast Track Adjuster
Infinity Insurance Company
03.2003 - 10.2007
Policy Services Specialist
Infinity Insurance Company
03.2003 - 10.2007
Salvage Payment Clerk
Infinity Insurance Company
03.2003 - 10.2007
Data Entry Clerk
Infinity Insurance Company
03.2003 - 10.2007
Associate of Applied Science Degree - Office Management
Virginia College
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