Keyani Tate
Columbus,GA
Summary
Detail-oriented healthcare professional with 4+ years of experience in medical claims processing, healthcare customer support, and provider communication. Skilled in resolving complex healthcare issues, troubleshooting claims and system discrepancies, managing high-volume phone, email, and case inquiries, and ensuring HIPAA compliance while delivering exceptional customer service.
Overview
7
7
years of professional experience
Work History
Medical Claims Processor
Corro Health
07.2022 - 05.2026
- Processed high volumes of medical claims with accuracy while meeting strict productivity and quality standards.
- Researched and resolved complex claims issues through collaboration with healthcare providers and internal departments.
- Communicated with providers regarding claim status, denials, and required documentation to ensure timely resolution.
- Improved processing efficiency by streamlining workflows and reducing claim errors.
- Reviewed medical documentation and assigned ICD-10-CM and CPT codes while maintaining compliance with healthcare regulations.
- Maintained detailed documentation and ensured HIPAA compliance when handling confidential patient information.
- Delivered exceptional customer service by resolving inquiries promptly and professionally.
Fraud Specialist
U.S. Bank
02.2023 - 05.2024
- Investigated complex account issues and resolved customer concerns while maintaining compliance with company policies.
- Provided outstanding phone-based customer support in a fast-paced environment.
- Trained new employees on company procedures, systems, and customer service best practices.
- Monitored accounts for suspicious activity and escalated issues when appropriate.
- Built strong customer relationships through effective communication and problem-solving.
Data Claims Specialist
Nelnet
09.2021 - 09.2022
- Processed healthcare claims while consistently meeting productivity and quality goals.
- Investigated billing discrepancies and resolved documentation issues to ensure claim accuracy.
- Built collaborative relationships with healthcare providers to facilitate timely claim resolution.
- Utilized healthcare systems and software to identify errors and improve processing accuracy.
- Maintained detailed records and ensured compliance with healthcare policies and procedures.
Healthcare Customer Service Representative
Claritev
10.2019 - 10.2020
- Served as the primary point of contact for healthcare members, resolving questions and concerns by phone.
- Assisted patients with benefits, claims, and healthcare-related inquiries while delivering excellent customer service.
- Protected confidential patient information by maintaining strict HIPAA compliance.
- Resolved escalated customer concerns professionally while maintaining a high level of customer satisfaction.
- Documented customer interactions accurately and collaborated with internal teams to resolve complex issues.
Education
High School Diploma - Phlebotomy
Kendrick High School
Columbus, GASkills
- Customer Service & Patient Support
- Provider Communication
- Medical Claims Processing
- Healthcare Operations
- Medical Terminology
- EMR Systems
- CRM/Ticketing Systems
- Claims Investigation & Resolution
- HIPAA Compliance
- Data Entry & Documentation
- Issue Resolution & Troubleshooting
- ICD-10-CM & CPT Coding
- Microsoft Office Suite
- Multitasking & Time Management
- Attention to Detail
- Conflict Resolution
- Team Collaboration
Timeline
Fraud Specialist
U.S. Bank
02.2023 - 05.2024
Medical Claims Processor
Corro Health
07.2022 - 05.2026
Data Claims Specialist
Nelnet
09.2021 - 09.2022
Healthcare Customer Service Representative
Claritev
10.2019 - 10.2020
High School Diploma - Phlebotomy
Kendrick High School