Kymberly Grant
Clinton,SC
Summary
Dedicated Customer Service professional with knowledge of service delivery and proven multitasking abilities. Committed to maintaining professional relationships to increase profitability and drive business results.
Overview
8
8
years of professional experience
Work History
Healthcare Customer Service Representative
Proactive MD
Greenville, SC
05.2024 - Current
- Processed paperwork related to medical claims processing, including authorizations, referrals, and pre-certifications.
- Provide exemplary customer service to patients by handling inquiries, scheduling appointments, and resolving issues efficiently.
- Maintain patient records and manage electronic health information systems to ensure accurate and timely data entry.
- Increased first-call resolution rates by carefully listening to customers' needs, and providing accurate information based on their inquiries.
Claims Representative
Palmetto Proactive Healthcare
Greenville, South Carolina
05.2020 - 08.2022
- Process and evaluate insurance claims for accuracy, ensuring proper documentation, coding, and compliance with policy terms.
- Review claimants' files, medical records, and other supporting documentation to assess coverage eligibility.
- Investigate and resolve claim disputes by communicating with claimants, policyholders, and service providers.
- Explain claims decisions and provide clarification on policy coverage to customers, maintaining high levels of customer satisfaction.
Medical Claims Processor
Chartspan Medical
Greenville, South Carolina
12.2016 - 12.2018
- Processed high volumes of medical claims accurately and efficiently under tight deadlines, ensuring prompt payment for services rendered.
- Verified patient insurance coverage and benefits for medical claims.
- Researched and resolved complex medical claims issues to support timely processing.
- Maintained a thorough understanding of the intricacies involved in processing medical claims for diverse healthcare specialties, enabling accurate and efficient claim adjudication.
Education
Associate of Applied Science - Medical Assisting
Brown Mackie College
Greenville, SC04-2012
Associate of Applied Science - Medical Admin
ECPI University
Greenville, SC05-2008
High School Diploma -
High School
Skills
- Insurance Verification
- Appointment Scheduling
- Claims Processing
- Call center experience
- Multitasking and Organization
- Customer Service
- Data Entry
- Complaint Handling
- Work Prioritization
- Escalation management
- Insurance claims processing
- Critical Decision-Making
Timeline
Healthcare Customer Service Representative
Proactive MD
05.2024 - Current
Claims Representative
Palmetto Proactive Healthcare
05.2020 - 08.2022
Medical Claims Processor
Chartspan Medical
12.2016 - 12.2018
Associate of Applied Science - Medical Assisting
Brown Mackie College
Associate of Applied Science - Medical Admin
ECPI University
High School Diploma -
High School
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