Marsha King
Milwaukee,WI
Summary
Qualified Advanced Technical Support Specialist with years of helpdesk and customer service experience. Adept at engaging customers by identifying issues and streamlining steps to resolve technical issues effectively.
Overview
8
8
years of professional experience
Work History
Technical Support Specialist
Virtual Benefits Administrator
07.2023 - Current
- Efficiently handle client support requests, ensuring adherence to service level agreements and turnaround time guidelines
- Monitor the VBA Help Desk mailbox for client inquiries and issues
- Proficient in creating and managing support tickets in the Incident Tracking tool
- Exceptional problem-solving capabilities and strong communication skills
- Skilled in conflict resolution, active listening, and maintaining a positive attitude
- Collaborative team player with keen attention to detail and dependability
- Flexible and adept at time management.
Senior Account Manager
Cardinal Health
10.2021 - 08.2022
- Oversee assigned Medical Products and Distribution customer(s) regarding insurance benefits
- Analyze and assist with EOBs and eligibility issues
- Manage DME order status to enhance order accuracy and minimize disruptions
- Improve the perfect order by addressing inventory issues, substitution maintenance, product standardization, and price accuracy
- Verify insurance through Emdeon, Availity, and Navinet
- Review clinical notes, identify doctor's written orders, and process prior authorizations
- Gather intake information, assess patient insurance benefits, and create patient records in the EMR system
- Qualify equipment based on insurance requirements and generate sales orders
- Communicate with dispatch to coordinate deliveries.
Senior Claims Specialist
Skygen USA
04.2018 - 10.2021
- Analyzed UB-04s/CMS-1500 medical claims for accuracy, completeness, and eligibility
- Determined coverage by examining benefits and calculated benefits for payment
- Resolved claim edits in the billing system and clearinghouse
- Provided second-tier support for various medical claims, including medical, therapy, ocular, PHO, and commercial dental
- Managed daily processing agent workflows, claims inventory, and pipeline
- Reviewed, moved, and transmitted electronic patient/provider files via the clearinghouse
- Coordinated benefits data for medical, ocular, and commercial dental claims
- Ensured appropriate rejection of claims and authorizations
- Demonstrated complete knowledge of insurance regulations, policies, and payment guidelines
- Managed On-Time tickets, addressed emails, and communicated potential issues for timely resolution.
Senior Call Center Specialist
Vestica Healthcare/Skygen USA
12.2015 - 04.2018
- Handled 200+ inbound calls daily for a Medicaid call center, providing stellar customer service
- Demonstrated in-depth knowledge of insurance referrals, verifications, and authorizations
- Identified needs and assisted with benefits and eligibility, billing and payments, or explanation of benefits (EOBs)
- Managed provider calls, communicating precise insurance coverage and verifying eligibility
- Conducted authorization and insurance verifications for a seamless healthcare process.
Education
PROJECT MANAGEMENT -
Gener8tor Skills Accelerator
01.2023
ADMINISTRATIVE ASSISTANT -
Gener8tor Skills Accelerator
01.2023
BEHAVIORAL SCIENCE -
University Of Phoenix
01.2005
Skills
- Software Debugging
- Customer Experience Management
- Debugging
- Performance Optimization
Core Business Competencies
- Medical and Commercial Dental Claims SME
- Strong Insurance and Claims knowledge
- Claims Analyst
- High Integrity and Leadership
- 3rd Party TPA for MCOs
- Problem-Solving Skills
- Strong Verbal and Written Communication Skills
- Provider Relations
- Client Experience Focused
- Team Lead and liaison
Timeline
Technical Support Specialist
Virtual Benefits Administrator
07.2023 - Current
Senior Account Manager
Cardinal Health
10.2021 - 08.2022
Senior Claims Specialist
Skygen USA
04.2018 - 10.2021
Senior Call Center Specialist
Vestica Healthcare/Skygen USA
12.2015 - 04.2018
PROJECT MANAGEMENT -
Gener8tor Skills Accelerator
ADMINISTRATIVE ASSISTANT -
Gener8tor Skills Accelerator
BEHAVIORAL SCIENCE -
University Of Phoenix
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