Latia Clarke
Sunrise,FL
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
9
9
years of professional experience
Work History
Remote Health Insurance Broker
QUOTE MANAGE
03.2021 - Current
- Help clients with reviewing their health care plan and help them evaluate their needs against the services and coverage they are eligible to receive
- Respond to customer inquiries and requests via telephone, email, and chat in a timely fashion. Document all inquires, requests, resolutions, and follow-up tasks prioritize tasks and manage time efficiently.
- Responded via telephone and email to questions regarding licensing, commissions, website logins and website navigation.
- Conducted research to answer questions and handle issues using multiple systems and resources.
- Adhered to health and prescription insurance products, delivery systems and claims systems.
Claims Analyst
Humana
07.2017 - 03.2021
- Viewed reports regularly to make sure processing was conducted efficiently.
- Researched and resolved complex medical claims issues to support timely processing.
- Paid or denied medical claims based upon established claims processing criteria.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Processed insurance payments and maintained accurate documentation of payments.
- Monitored and updated claims status in claims processing system.
- Identified and resolved discrepancies between patient information and claims data.
Escalation Supervisor
Convey Health Solutions
10.2014 - 07.2017
- Provide immediate assistance and support to, concerning escalated customer inquiries and issues
- Work with internal departments and contacts to resolve any discrepancies with the customers’ accounts
- Assist with updating account information, providing detailed plan information, and resolving issues with utilization of the plan
- Research any discrepancies with premium billing and prescription claims processed
- Assist pharmacies with prescriptions denials, errors, and verifying benefits
- Member services/convey health solutions
- Updated account information to maintain customer records.
- Investigated and resolved customer inquiries and complaints quickly.
- Educated customers about billing, payment processing and support policies and procedures.
Education
Associate of Science - Nursing
Broward College
Fort Lauderdale, FL05.2021
Skills
- Ability to work accurately and effectively in a fast paced environment
- Proven record of providing strong, accurate and effective client service
- Excellent problem solving skills
- Experience in effectively analyzing issues and identifying root causes to prevent reoccurrence
- Strong knowledge of systems and technology
- Strong verbal and written communication skills
- Thorough comprehension of contract provisions and administrative policies and procedures
- In-depth knowledge of insurance products and processes
- Displays integrity through transparency, honest dealings, predictable reactions and well-controlled emotions; demonstrates the ability to be fair and consistent in all professional dealings
- Proficient with Microsoft Tools including PowerPoint, Word and Excel
- Knowledge of Salesforce
Timeline
Remote Health Insurance Broker
QUOTE MANAGE
03.2021 - Current
Claims Analyst
Humana
07.2017 - 03.2021
Escalation Supervisor
Convey Health Solutions
10.2014 - 07.2017
Associate of Science - Nursing
Broward College
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