Summary
Work History
Education
Skills
Timeline
Generic

Latricia Caldwell

Seale,AL

Summary

Customer service professional with 10 years of experience seeking Customer Service Representative role. Proven track record in patient/client relations, records management, and office management, with expertise in financial transactions and administrative support. Strong skills in workflow planning, clerical support, and proficiency in MS Office, ensuring high-quality service and seamless operations.

Work History

Benefit Coordinator

Nexus Pain Center
  • Verify insurance benefits, obtain authorizations/re-certifications. Provide appropriate follow-up communication with patients for adherence to Insurance plan benefits. Responsible for pre-certification of patient insurance before care or treatment is scheduled. Proficient in obtaining medical benefits by phone and by insurance portals.

Insurance Verification Specialist

Gastrointestinal Diseases
  • Conducts insurance verification and explains deductibles, copayments, and coinsurance to clients, ensuring compliance with HIPAA regulations.
  • Manages communications with healthcare professionals via calls, emails, and faxes to facilitate prior authorizations.
  • Identifies and develops process improvements, optimizing operating systems and refining training programs to enhance quality assurance and claims analysis.

Patient Service Specialist

Emory Rehab. Outpatient Center
  • Managed financial transactions with precise cash handling, balanced cash drawers, and maintained petty cash, ensuring high standards of accuracy and accountability.
  • Facilitated daily operational efficiency by executing opening and closing procedures for registers and approving transaction overrides, enhancing service delivery.
  • Supported financial oversight by preparing bank deposits, reconciling statements, and maintaining billing spreadsheets, contributing to the organization's fiscal integrity.

Production Team Member

Kia Motors Manufacturing Georgia, Inc.
  • Assembled vehicles on the production line, ensuring adherence to strict quality control standards.
  • Contributed to the organization's commitment to manufacturing excellence through consistent performance.
  • Maintained high productivity levels while supporting team objectives in a fast-paced environment.

Front Office Assistant

Piedmont Physicians Urology
  • Coordinated patient appointments and maintained confidential records to ensure seamless office operations.
  • Delivered high-quality administrative support to healthcare professionals, enhancing overall efficiency.
  • Managed patient flow effectively, contributing to an improved healthcare experience.

VA Claims Analyst II/Legal Resources

Aspirion Health Resources
  • Analyzed complex veteran affairs claims and legal resources, ensuring compliance with standards and regulatory requirements.
  • Evaluated and processed claims with a focus on accuracy, contributing to streamlined operations.
  • Collaborated with cross-functional teams to enhance claim processing efficiency and accuracy.

Utilization Management Rep II/ Claims Rep I

Anthem
  • Conducted comprehensive reviews of medical service and equipment requests to ensure adherence to coverage policies and patient care standards, facilitating informed decision-making.
  • Coordinated daily intake and processing of prior authorization requests, ensuring compliance with healthcare policies and regulatory requirements.
  • Managed communication between healthcare providers and insurance adjusters to maintain optimal patient outcomes and deliver efficient service to providers and members.

Education

Medical Billing & Coding, Medical Billing & Coding

1 on 1 Technical College
Phenix City, Alabama

High School Diploma - undefined

El Cajon Valley High School
El Cajon, CA
01.1997

Skills

  • Claims Analysis
  • Insurance Verification
  • Risk Management
  • Insurance Administration
  • Prior Authorization
  • Records Management
  • Benefits and Eligibility
  • Case Management
  • Project Management
  • HIPAA Compliance
  • Patient/Client Relations
  • Office Management
  • Workflow Planning/Prioritization
  • Clerical Support
  • Resource Management
  • Computer Hardware/Software: Windows XP
  • Proficient With MS Office
  • Works
  • Excel
  • Outlook
  • Internet Explorer

Timeline

Insurance Verification Specialist

Gastrointestinal Diseases

Patient Service Specialist

Emory Rehab. Outpatient Center

Production Team Member

Kia Motors Manufacturing Georgia, Inc.

Front Office Assistant

Piedmont Physicians Urology

VA Claims Analyst II/Legal Resources

Aspirion Health Resources

High School Diploma - undefined

El Cajon Valley High School

Benefit Coordinator

Nexus Pain Center

Utilization Management Rep II/ Claims Rep I

Anthem

Medical Billing & Coding, Medical Billing & Coding

1 on 1 Technical College

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Latricia Caldwell