Kiera Daniels
Pelham,GA
Summary
Results-driven professional with a proven ability to adapt swiftly to new challenges while maintaining strong client and team relationships. Demonstrates exceptional problem-solving skills and a commitment to fostering team success. Highly motivated with a robust work ethic, adept at independently mastering new skills and driving positive outcomes.
Overview
11
11
years of professional experience
Work History
Medical Claims Representative
RxCrossroads By McKesson
Remote
08.2024 - 01.2025
- Researched complex cases as needed by consulting with physicians or other health care providers.
- Modified and updated existing policies and claims to reflect change in beneficiary, amount of coverage or type of insurance.
- Reviewed patient records to verify insurance coverage and eligibility for services.
- Used contract notes and processing manual to correctly apply group-specific classifications to claims.
- Reviewed administrative guidelines whenever questions arose during processing of claims.
- Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
- Reviewed claims for accuracy before submitting for billing.
Customer Service Representative
VXI
Remote, GA
08.2023 - 08.2024
- Answered customer inquiries and provided accurate information regarding products and services.
- Assisted customers with product selection, ordering, billing, returns, exchanges and technical support.
- Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.
- Assisted 100 plus callers with Apple products.
Patient Access Specialist
LadyLuvs Collection LLC
Remote, GA
07.2021 - 08.2023
- Responded promptly to customer inquiries regarding account balances, billing statements, payment history.
- Assisted with scheduling appointments, pre-registration activities, verifying demographics and insurance information.
- Resolved issues related to registration process including eligibility verification and authorization problems.
- Analyzed reports generated by EHR system in order to identify areas of improvement within the workflow processes.
- Managed 100 plus calls per day.
Healthcare Customer Service Representative
Teleperformance
Remote, GA
12.2018 - 06.2021
- Scheduled appointments for patients using the electronic health records system.
- Managed incoming calls from patients and other healthcare facilities to provide information or schedule services.
- Processed paperwork related to medical claims processing including authorizations, referrals, pre-certifications.
- Verified demographics and insurance information to register patients in computer system.
- Managed 150 plus calls per shift.
Store Manager
Dollar General
Pelham, GA
11.2013 - 12.2018
- Conducted daily store operations, including opening and closing procedures and cash handling.
- Developed strategies to maximize sales and profitability.
- Established customer service standards, and monitored staff compliance.
- Recruited, trained, and supervised new employees.
- Directed team of over 10 staff members.
- Delegated work to staff, setting priorities and goals.
- Enhanced customer satisfaction and store operations through relationship building and daily problem-solving.
Education
Bachelor of Science - Criminal Justice
Grantham University
Lenexa, KS05-2015
High School Diploma -
Mitchell Baker High School
Camilla, GA05-2007
Skills
- Customer Service
- Call Center Operations
- Staff management
- Skilled in utilizing CRM software
- Detail-oriented data input
- Experienced with Microsoft software
- Billing and Payment Processing
- In-depth knowledge of medical terminology
- Team strategic leadership
- Employee training
- HIPAA Compliance
- Claims processing
- Insurance verification
- Problem solving
- Consistent precision in tasks
- Collaborative teamwork
- Clear and concise communication abilities
Timeline
Medical Claims Representative
RxCrossroads By McKesson
08.2024 - 01.2025
Customer Service Representative
VXI
08.2023 - 08.2024
Patient Access Specialist
LadyLuvs Collection LLC
07.2021 - 08.2023
Healthcare Customer Service Representative
Teleperformance
12.2018 - 06.2021
Store Manager
Dollar General
11.2013 - 12.2018
Bachelor of Science - Criminal Justice
Grantham University
High School Diploma -
Mitchell Baker High School
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