KORONISHA SCOTT
Summary
Results-driven professional provides customers with tailored solutions to meet needs. Successfully establishes relationships with customers and delivers quality service. Agile individual with excellent communication and customer service skills.
Overview
8
8
years of professional experience
Work History
Medical Insurance Specialist
Elevance Health
10.2022 - 11.2023
- Verified patient insurance coverage and benefits for medical claims.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Identified and resolved discrepancies between patient information and claims data.
- Reviewed provider coding information to report services and verify correctness.
- Monitored and updated claims status in claims processing system.
- Researched and resolved complex medical claims issues to support timely processing.
- Followed up on denied claims to verify timely patient payment and resolution.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Monitored customer feedback and identified areas of improvement.
- Generated leads through cold-calling, networking and other outreach methods.
- Scheduled appointments with applicants to gather information and explain benefits processes.
- Handled customer complaints quickly and professionally to restore customer confidence and prevent loss of business.
Health Insurance Advisor
Broadpath Healthcare Solutions
10.2019 - 09.2022
- Answered inbound calls from existing and future policyholders to answer inquiries and discuss insurance options.
- Educated clients about health insurance coverage options, benefits and costs.
- Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
- Developed relationships with providers and networks to achieve favorable client coverage.
- Monitored customer feedback and identified areas of improvement.
- Collected premiums on or before effective date of coverage.
- Generated leads through cold-calling, networking and other outreach methods.
Banking Customer Service Representative
TSYS
02.2018 - 09.2019
- Assisted customers with navigating bank systems, completing transactions and opening or closing accounts.
- Processed various transactions with accuracy and according to bank standards and legal requirements.
- Strengthened customer relationships by upholding strict standards and delivering fast, friendly customer service.
- Collected feedback from customers to help improve service delivery and banking processes.
- Reviewed reports and individual transactions which appeared suspicious to uncover possible fraudulent activity.
- Performed risk assessments to determine level of fraud risk and prioritize investigations.
- Worked with third-party vendors to access and analyze data and systems.
- Evaluated customer data to identify and prevent fraudulent activities.
- Addressed customer inquiries, requests and complaints with courtesy and professionalism.
- Met customer call guidelines for service levels, handle time and productivity.
- Delivered prompt service to prioritize customer needs.
Production Line Assembly Worker
NCR
11.2015 - 12.2017
- Set up and operated greasing equipment to lubricate components, sub-assemblies or assemblies.
- Used established assembly instructions to complete jobs quickly, accurately, and with zero errors.
- Completed durable assemblies and subassemblies with hand and power tools.
- Boxed, labeled, and transported items to support assembly operations.
- Kept work areas clean by removing trash and debris and organizing tools in preparation for next shift.
- Performed visual and functional inspection of components to determine quality and identify defects.
- Assembled components with minimal supervision, exceeding expected project milestones.
- Trained and mentored new employees to apply best practices on assembly line operations and comply with procedures and regulations.
- Collaborated with engineering teams to improve production efficiency.
- Managed inventory of parts and components.
- Facilitated collaboration between production and other departments.
Education
High School Diploma -
Stewart County High School
Lumpkin, GA05.2013
Skills
- Electronic Health Records
- Claims Processing
- Data Entry Accuracy
- Attention to Detail
- Medical Terminology
- HIPAA Compliance
- Teamwork Abilities
- Insurance Claims Processing
- Customer Follow-Up
- Insurance Coverage Verification
- Call Center Customer Service
- Time Management
Awards And Acknowledgements
Perfect Attendance
Timeline
Medical Insurance Specialist
Elevance Health
10.2022 - 11.2023
Health Insurance Advisor
Broadpath Healthcare Solutions
10.2019 - 09.2022
Banking Customer Service Representative
TSYS
02.2018 - 09.2019
Production Line Assembly Worker
NCR
11.2015 - 12.2017
High School Diploma -
Stewart County High School
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