Megan E. Spivey
Temple Terrace
Summary
Eager to leverage my extensive customer service background, adept data entry skills, and managerial experience to contribute to a dynamic healthcare team. I am committed to delivering exceptional service, optimizing operational processes, and cultivating a positive customer experience. Seeking a challenging role where I can utilize my skills to drive customer satisfaction and contribute to the success of the organization.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Hospital Unit Coordinator
Advent Health
02.2022 - Current
- Achieved appropriate patient flow by admitting, transferring and discharging patients in computer system and notifying appropriate personnel of patient status verbally and through signage.
- Coordinated and maintained referral sources related to admissions, discharges and follow up services to sustain daily census requirements.
- Received physicians and visitors on 38 patient unit, identifying, acknowledging and responding to patient, physician and staff needs to meet operational and care needs of parties.
Senior Fraud Resolutions Specialist
Capital One Bank
04.2018 - 09.2021
- Responsible for the intake and setup of fraud claims. Reviews and analyzes claim information from multiple sources.
- Responsible for the retrieval of all documentation required for the research and resolution of claims received.
- Properly Researched and retrieve all relevant data from various sources to resolve claim.
Processing Executive
Cognizant Technology Solutions
06.2016 - 05.2017
- Worked on the delegate and encounter teams to price and edit claims.
- Competed data entry of provider and member demographics to ensure timely payment of claims.
- Processed and adjudicated medical claims.
- Resolved pending claims using state and federal regulations and specific health plan criteria.
Operations Intake Coordinator
WellCare Health Plans Inc.
04.2014 - 06.2016
- Developed team communications and information for training and meetings.
- Conducted intake and appropriate classification of authorization requests for medical procedures.
- Completed initial data entry of all authorization requests where compliance and accuracy are critical.
- Ensured expedited requests were escalated and processed immediately to ensure treatment for members.
Fraud Recovery Coordinator
Capital One Bank
04.2013 - 04.2014
- Investigated account activity to identify disputes rights, fraud, or other account solutions.
- Verified account activity and customer identity.
- Properly tracked and stored claim/dispute information and took necessary steps to resolve discrepancies with merchants.
Customer Service Coordinator
Capital One Bank
06.2011 - 04.2013
- Assisted cardholders with making payments, credit limit increases, balance transfers, and making claims.
- Updated account information and completed accurate documentation, performed account level research and advised customer of products that may benefit them.
- Lead team meetings, attended weekly Train the Trainer meetings, and led the team as the Subject Matter Expert (SME).
Education
Some College (No Degree) - Practical Nursing
Rasmussen University
Brandon, FL06-2025
Skills
- Conflict resolution
- Microsoft Word competency
- Medication administration
- Critical thinking
- Multitasking and organization
- Patient advocacy
- Recording vital signs
Certification
- Basic Life Support (BLS) American Heart Association
- Certified Medical Technician
Timeline
Hospital Unit Coordinator
Advent Health
02.2022 - Current
Senior Fraud Resolutions Specialist
Capital One Bank
04.2018 - 09.2021
Processing Executive
Cognizant Technology Solutions
06.2016 - 05.2017
Operations Intake Coordinator
WellCare Health Plans Inc.
04.2014 - 06.2016
Fraud Recovery Coordinator
Capital One Bank
04.2013 - 04.2014
Customer Service Coordinator
Capital One Bank
06.2011 - 04.2013
Some College (No Degree) - Practical Nursing
Rasmussen University
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