Markicia Hudson
Sumter,SC
Summary
Accomplished Claims Processor with a track record of enhancing customer relations and reducing overdue balances at Blue Cross Blue Shield Of SC. Skilled in claims review and negotiation, adept at resolving complex issues and fostering positive business relationships. Achieved high accuracy in transaction reconciliation, demonstrating exceptional stress tolerance and precision. Gifted in working with stressed, confused and upset individuals in need of benefits information and supportive guidance to navigate Microsoft systems. Effective at operating within Hippa regulations and Medical Department guidelines to manage telephone calls, emails, letters and in-person requests for assistance.
Overview
7
7
years of professional experience
Work History
Claims Processor
Blue Cross Blue Sheild Of SC
02.2021 - Current
- Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries.
- Handles situations which may require adaptation of response or extensive research.
- Identifies incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines.
- Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines.
- Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes.
- Ensures claims are processing according to established quality and production standards.
- Identifies complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution.
- Identifies and reports potential fraud and abuse situations.
Receptionist
Glasser And Glasser Law
01.2020 - 08.2020
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Confirmed appointments, communicated with clients, and updated client records.
- Answered phone promptly and directed incoming calls to correct offices.
- Kept reception area clean and neat to give visitors positive first impression.
- Resolved customer problems and complaints.
- Handled cash transactions and maintained sales and payments records accurately.
- Exceeded daily scan quotas while maintaining high level of accuracy, contributing to overall department success.
- Ensured compliance with privacy regulations by maintaining strict confidentiality regarding sensitive client information.
Debt Collector
Portfolio Recovery Associates
09.2017 - 01.2020
- Collected on delinquent accounts to reduce overdue balances.
- Resolved customer disputes and disagreements through professional, calm communication to find mutually beneficial solutions.
- Educated debtors about repayment options, enabling them to make informed decisions while preserving positive business relationships.
- Developed strong relationships with customers to foster timely payments and account resolution.
- Worked in call center environment handling manual and automatically dialed outbound calls.
- Achieved successful settlements by skillfully negotiating terms agreeable to both parties involved in disputes.
Education
High School Diploma -
Crestwood High School
Sumter, SC06.2010
Skills
- Claims review
- Accuracy and Precision
- Transactions reconciliation
- Claims
- Payment Acceptance
- Business Correspondence Writing
- Negotiation
- Call center experience
- Issue investigation
- Stress Tolerance
- History research
- Payment Processing
Timeline
Claims Processor
Blue Cross Blue Sheild Of SC
02.2021 - Current
Receptionist
Glasser And Glasser Law
01.2020 - 08.2020
Debt Collector
Portfolio Recovery Associates
09.2017 - 01.2020
High School Diploma -
Crestwood High School