Monique Lee
Columbus,GA
Summary
Results-oriented Intake Representative with extensive healthcare experience, specializing in medical terminology, insurance verification, and claims processing. Demonstrated ability to enhance patient care coordination while excelling in high-volume call environments. Committed to optimizing intake processes and delivering exceptional customer service. Quick learner with a passion for continuous improvement and adapting to new challenges.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Claims Customer Care Specialist
Allstate
Remote, GA
04.2022 - 01.2025
- Assisted customers in filing initial insurance claims by guiding them through the process step-by-step
- Investigated and evaluated claims by gathering relevant information from various sources such as clients, witnesses, submitted documents, police reports, repair estimates, etc
- Assessed damages and determined appropriate compensation based on policy terms, coverage limits, and applicable laws/regulations
- Communicated effectively with policyholders regarding the status of their claims throughout the entire process
- Adhered to company policies and industry regulations while handling sensitive customer information with confidentiality
- Collaborated with insurance adjusters, attorneys, and other professionals to gather necessary documentation for claim processing
- Maintained detailed records of all interactions, correspondence, and transactions related to each claim
- Resolved escalated customer complaints promptly by providing empathetic support and finding appropriate solutions
- Participated in ongoing training programs to stay updated on changes in insurance laws/regulations
Overnight Stocker Associate
Walmart
Columbus, GA
07.2021 - 04.2022
- Restocked shelves and/or inventory in the Walmart store outside operation hours
- Demonstrated strong attention to detail when checking expiration dates on perishable goods, ensuring compliance with quality standards
- Utilized handheld scanners and computer systems to label inventory stock and assist with e-commerce personal shopping to include prepping, staging, and dispensing as needed
- Provided excellent customer service by promptly assisting shoppers with locating specific products or answering inquiries about availability
- Followed safety protocols while handling heavy equipment such as pallet jacks or forklifts, preventing accidents or injuries in the workplace
- Contributed to maintaining a clean and organized backroom area by properly storing excess merchandise and removing empty boxes
- Managed time effectively during busy periods by prioritizing tasks based on urgency and demand from different departments within the store
Poultry Processing Shipping Clerk I
Alatrade
Phenix City, AL
09.2017 - 10.2018
- Collaborated with team members to achieve daily production targets while maintaining high quality standards for efficient order fulfillment
- Managed multiple priorities simultaneously while maintaining attention to detail
- Demonstrated strong problem-solving skills when addressing unexpected challenges during the shipping process
- Increased productivity by developing standardized work instructions for common shipping tasks such as filing, maintaining and updating shipping records, performing regular inventory counts, and creating labels for incoming and outgoing stock
- Utilized shipping management software to track and monitor incoming and outgoing shipments, process and prepare shipping documents to include bills of lading, invoices, and custom forms
- Provided training to new employees on proper packaging techniques, labeling requirements, and safety protocols
Utilization Management Representative
Anthem Blue Cross, Blue Shield
Columbus, GA
11.2016 - 04.2017
- Collaborated with healthcare providers and insurance companies to gather necessary information for precertification and prior authorization review
- Ensured compliance with applicable laws, regulations, accreditation standards, and contractual requirements related to utilization management practices to include upholding the confidentiality and privacy of patient information in accordance with HIPAA regulations
- Provided timely responses to inquiries from healthcare providers regarding authorization status or coverage determinations
- Maintained accurate documentation of all review activities in accordance with regulatory requirements
- Provided education on utilization management processes to policyholders, patients, and healthcare professionals as needed
- Collaborated with internal departments such as claims processing or customer service teams to resolve issues related to utilization review
Data Entry Operator I/Exceptions Specialist
BancTec
Columbus, GA
05.2016 - 11.2016
- Maintained a high level of attention to detail while reviewing and reconciling insurance payments to ensure accurate account posting
- Utilized spreadsheet software (e.g., Microsoft Excel) to organize, manipulate, and analyze large data sets
- Participated in team meetings to discuss process improvements and share best practices for efficient data entry processing
Call Center Representative
St Francis Columbus Clinic
Columbus, GA
10.2014 - 04.2016
- Built rapport with customers by listening to their concerns and responding empathetically to questions about insurance, appointments, and medical procedures
- Collaborated with more than 10 healthcare providers to coordinate and support individual appointment availability, thereby improving patient access to essential medical services
- Ensured the precision of patient records by systematically updating demographic information, insurance details, and medical history within electronic health record systems
- Strictly adhered to HIPAA guidelines to ensure patient confidentiality in all interactions and data handling
- Served as a liaison between patients and medical staff via incoming calls, emails, and messages effectively communicating and accurately documenting patient preferences, concerns, or special requests
Culinary Technical Assistant/Cashier
Muscogee County School District
Columbus, GA
11.2009 - 10.2014
- Ensured compliance with dietary guidelines for federal school meal programs, including portion sizes, nutritional requirements, and preparation of special meals for students with allergies or specific dietary restrictions
- Implemented strategies for reducing food waste through careful planning of quantities prepared each day ensuring optimal stock levels were always maintained
- Monitored food temperatures regularly to guarantee proper storage and prevent spoilage or contamination
- Maintained cleanliness and sanitation standards in the cafeteria, ensuring a safe and healthy environment for students
- Demonstrated excellent time management skills by efficiently serving meals within designated lunch periods
- Maintained accurate records of daily sales transactions and meal counts for reporting purposes
- Assisted in training new cafeteria workers on food safety procedures, customer service techniques, and daily tasks
Hardlines Associate/cashier
Kmart Corporation
Columbus, GA
10.2013 - 02.2014
- Provided exceptional customer service by assisting customers with product inquiries, locating items, and processing transactions
- Performed price checks and updated pricing labels as necessary to reflect current promotions or discounts
- Collaborated with team members to create visually appealing merchandise displays that attracted customer attention
- Managed cash register operations, accurately handling cash transactions and providing correct change to customers
- Maintained a clean and organized sales floor, ensuring products were properly displayed and shelves were fully stocked
Information Service Assistant
AT&T Mobility
Columbus, GA
11.2007 - 04.2008
- Accurately and effectively handled customer inquiries for the information center (formally known as 411)
- Retrieved phone numbers, addresses, directions, and movie listings from company database at a rate of 28 seconds per call and connected customers to requested numbers
- Assisted with providing customers with account credits as needed
- Worked with team to maintain quality service
Technical Customer Service Representative I
TSYS Acquiring Solutions
Columbus, GA
09.2005 - 08.2007
- Managed a high volume of incoming calls while maintaining quality standards for response time and issue resolution
- Developed strong product knowledge across multiple software applications to provide accurate information and guidance to customers
- Provided step-by-step instructions to clients and brokers on how to use POS terminal and software applications effectively
- Demonstrated expertise in troubleshooting network connectivity problems, assisting customers with terminal configurations and resolving connection issue
- Provided detailed transaction and financial information to merchants and clients
- Documented all customer interactions accurately in the CRM system for future reference and analysis
Education
High School Diploma -
Kendrick High School
Columbus, GA05.2004
Skills
- Claims management
- Customer service
- Telephone operations
- Effective Troubleshooting Skills
- Effective Communication
- Data Entry Proficiency
- Administrative experience
- Utilization management
- Microsoft Office
- Technical support
- Claims processing
- HIPAA compliance
- Phone etiquette
- Teamwork
- POS System Proficiency
- Culinary Operations Management
- Electronic Medical Records Management
- Certified in ServSafe Standards
- Team player
- Culinary Experience
- Software Competency
- Organizing and prioritizing work
- Problem-solving aptitude
- Numeracy skills
- Multitasking Abilities
- Insurance coverage verification
Certification
- Food Handler Certification.
- Driver's license.
- ServSafe
References
References available upon request.
Timeline
Claims Customer Care Specialist
Allstate
04.2022 - 01.2025
Overnight Stocker Associate
Walmart
07.2021 - 04.2022
Poultry Processing Shipping Clerk I
Alatrade
09.2017 - 10.2018
Utilization Management Representative
Anthem Blue Cross, Blue Shield
11.2016 - 04.2017
Data Entry Operator I/Exceptions Specialist
BancTec
05.2016 - 11.2016
Call Center Representative
St Francis Columbus Clinic
10.2014 - 04.2016
Hardlines Associate/cashier
Kmart Corporation
10.2013 - 02.2014
Culinary Technical Assistant/Cashier
Muscogee County School District
11.2009 - 10.2014
Information Service Assistant
AT&T Mobility
11.2007 - 04.2008
Technical Customer Service Representative I
TSYS Acquiring Solutions
09.2005 - 08.2007
High School Diploma -
Kendrick High School
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