Kelly Brannon
Claims Processor III
Charleston,WV
Summary
Diligent Claims Processor versed in insurance processes and claims procedures. Offers great attention to detail and time management abilities to successfully handle large volume of claims. I strive to be accurate and thorough with focus on completing error-free work in line with processing guidelines.
Overview
18
18
years of professional experience
Work History
Claims Processor III
CASCI
06.2014 - Current
- Adhere to the company policies and Federal guidelines when processing claims
- Process claims accurately and timely
- Process institutional, HCFA and Member submitted claims based on their agreement with the Federal Employment Program
- Assisted in changes to the processing manual for Provider Number Coding as well as assisting others with provider edits
- Worked on the Provider Number Coding project to assist with Machine Learning as well as other scripting projects
- Member and Facilitator for Peer Engagement and Positivity (PEP) Squad boosting moral throughout the department for 3 years
- Assist other processors with any questions they may have with claims or the processing manual
- Member of multiple ERG's and planned many company events for the Hispanic ARG (now known as the CareFirst Familia ERG)
- Planned for the Department to participate in the United Way Day of Caring event for 2021 -2023 to help give back to the community.
- Managed workload and priorities to meet claims processing meet deadlines.
Customer Service Representative II
CASCI
03.2010 - 06.2014
- Assist FEP BlueCross BlueShield members with their inquiries via written correspondence and telephone conversation
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Worked daily reports in Member Services for DC, Maryland and Overseas
- Assisted many other associates and trainees with any questions about inquiries they received via correspondence or phone as well as assisted with their reports
- Handled elevated issues given to me by Management
- Was a Dedicated Representative for an Overseas member
- Tested new systems for claims as well as phone systems
- Received numerous All-Star Line Up awards, MVP of the Month and was awarded CSR of the Year.
Special Services Associate
Home Depot
04.2008 - 02.2010
- Maintained up-to-date knowledge of product and service offerings to serve as informational resource to customers and team members.
- Operated cash register and assisted co-workers with complex transactions such as special orders and pro-desk/business orders.
- Contacted customers to let them know when the order was due in and when the order arrived at the store
- Made phone calls to vendors to follow up on special orders
- Set up installations for services offered thru Home Depot for customers and businesses
- Ran daily reports and worked inventory reports
- Assisted customers in the Paint Department if a sales associate was not available.
- Served senior member of customer service team by training new hires, answering coworkers' questions and encouraging adherence to company policies.
Receptionist/Billing
Shining Light Daycare center (dba zion child development center)
06.2006 - 01.2008
- Managed multiple tasks and met time-sensitive deadlines.
- Kept reception area clean and neat to give visitors / parents positive first impression.
- Greeted incoming visitors/parents professionally and provided friendly, knowledgeable assistance, answered general questions, gathered nature of visit and directed to specific offices and or classrooms.
- Answered central telephone system and directed calls accordingly.
- Handled assignments independently with good judgement and critical thinking skills.
- Billed daycare fees to parents, WV Connect Childcare and WV Nutrition Program.
- Assisted parents / guardians signing their children in / out.
- Assisted in classrooms as needed.
Education
unfinished - sociology
West Virginia State University
Skills
TeamworkProblem solvingAdaptabilityInterpersonal skillsCommunicationComputer skills
Multitasking Abilities
Claims management
Claims
Processing medical claims
Insurance claims cases
Thorough claims reviews
Timeline
Claims Processor III
CASCI
06.2014 - Current
Customer Service Representative II
CASCI
03.2010 - 06.2014
Special Services Associate
Home Depot
04.2008 - 02.2010
Receptionist/Billing
Shining Light Daycare center (dba zion child development center)
06.2006 - 01.2008
unfinished - sociology
West Virginia State University