Mykel Berry
Brooklyn
Summary
Customer service representative with a strong commitment to providing exceptional support and fostering positive customer relationships. Demonstrates excellent communication and people skills, ready to learn and adapt in a dynamic environment. Dedicated to punctuality and delivering high-quality service to enhance customer satisfaction.
Experienced in processing and reviewing insurance claims, ensuring compliance with company policies while enhancing claims accuracy. Collaborated effectively with healthcare providers to verify patient information, which facilitated timely claim resolutions and improved customer satisfaction. Analyzed claim data to identify trends and discrepancies, resulting in enhanced reporting and operational efficiency. Conducted audits on processed claims to ensure adherence to regulatory standards, minimizing errors and compliance issues.
Overview
12
12
years of professional experience
Work History
Claim Processor
Athena Consulting Llc
Gaithersburg
08.2025 - 03.2026
- Processed and reviewed insurance claims, ensuring compliance with company policies and improving claims accuracy.
- Collaborated with healthcare providers to verify patient information, facilitating timely claim resolution and enhancing customer satisfaction.
- Analyzed claim data to identify trends and discrepancies, leading to improved reporting and operational efficiency
- Conducted audits on processed claims to ensure adherence to regulatory standards, minimizing errors and compliance issues.
- Processed a high volume of incoming claims in accordance with established policies and procedures.(120 + a day )
- Verified claim data correctness in preparation for processing.
Patient Service Representative / Claim Processor ( Hybrid)
Advanced Radiology | Aiello Center at BWMC
Glen Burnie
02.2023 - 02.2025
- Facilitate patient support, fostering a welcoming environment and enhancing patient experiences.
- Coordinate with medical staff, ensuring accurate information transfer for improved care continuity.
- Maintain detailed records of patient interactions, ensuring compliance and operational accuracy.
- Optimize appointment scheduling, reducing wait times and improving service efficiency.
- Experienced in coding using ICD-10 & CPT Coding
- Evaluated medical records for accuracy of diagnosis coding and appropriate procedure coding
- Reviewed medical records for complete and accurate documentation to support the assigned codes
- Resolved billing inaccuracies
- Knowledge of Medicare (A,B,C,D) & payers policies and guidelines for coverage
- Identified gaps in claims reporting processes.
- Identified high-risk claims.
- Streamlined claims approval processes.
- Processed claims according to client guidelines.
- Identified gaps in claims reporting processes.
- Assisted with preparing quarterly claims performance reports.
- Identified processing discrepancies.
- Improved claim approval accuracy.
- Ensured all settlements met state regulations.
- Identified recurring claim issues.
- Ensured claims met eligibility criteria.
- Processed insurance claims.
- Handled high-volume claims.
- Achieved timely resolutions.
- Investigated discrepancies.
Healthcare Claim Rep (Remote)
John Hopkins Health LLC
Glen Burnie
11.2019 - 12.2022
- Provided empathetic assistance to patients, fostering trust and enhancing their overall healthcare experience.
- Monitored service metrics, identifying trends to implement changes that led to substantial improvements in response times.
- Worked with multidisciplinary teams to streamline communication, ensuring timely updates and enhanced patient care.
- Maintained accurate patient records and documentation, supporting compliance with healthcare regulations and enhancing operational efficiency.
- Gathering information to assist and fulfilled patient needs and education on important policies procedures
- Obtain Pre-Authorization from insurance carriers for medical service within a designated time frame.
- Review denial reasons advocate for patients while obtaining approval/denial letters, informing the office of results and providing appeal services
- Build relationships with physician offices and clinics by initiating contact via email, answering phone/ email / Live Chat correspondence promptly and responding within one business
- Successfully delegated case assignments within the claims team.
- Reduced claim errors.
- Analyzed claims data to detect trends.
- Handled escalations from dissatisfied clients.
- Verified policy wording in submitted claims.
Financial Services Representative
S3 Shared Service Solutions
Linthicum
03.2017 - 10.2019
- Managed client accounts to ensure timely payments, significantly reducing outstanding debts and enhancing cash flow.
- Worked closely with cross-functional teams to develop tailored financial solutions, boosting client satisfaction and retention.
- Provided exceptional customer service, fostering trust and rapport that contributed to long-term client relationships.
- Assisted customer navigating banking system completing transaction and opening or closing account
- Answering telephone inquiries on checking and saving accounts, loans and line of credits
- Trained a team of 10 associates
- Answering inquiries on verifying payment with payment amount and dates
Patient Service Representative
Call 4 Health
Linthicum Heights
06.2014 - 09.2016
- Managed patient inquiries, streamlining appointment scheduling, which led to a noticeable decrease in wait times.
- Importing patients in the system to confirm eligibility and verifying insurance benefits and inputting info in EPIC
- Collect any source of payment from patient that using large variety of insurance programs adjusting amount based on specific plan directives
- Explain financial responsibilities to patient as well as payment options including financial assistance program for uncovered bills and potential collection
- Scanned patient and registration document into electronic patient records
- Managed daily patient appointments and schedules.
- Liaised with medical billing department.
- Cut down scheduling gaps.
- Utilized clear communication.
- Processed insurance pre-authorizations for surgical patients.
- Decreased claim denials.
- Followed up with post-procedure instructions.
- Filled cancellations to increase clinic capacity.
Education
High School -
Walbrook High School
Baltimore, MDSkills
- Hospitality software proficiency
- Problem-solving under pressure
- Strong written and verbal communication
- Efficiency in Check-in Processes
- CRM System Experience
- Customer service excellence
- Multitasking in high-pressure environments
- VIP Guest Services and Relations
- Guest issue resolution
- Guest retention strategies
- Phone and email etiquette
- Front desk management
- Data entry accuracy
- Call escalation reduction
- Customer Retention Improvement
- Phone etiquette
- Inbound Call Management
- Handling high call volumes
- Email support
- Live chat support
- Training and mentorship
- New Hire Onboarding
- Call quality improvement
- CRM software proficiency
- First Call Resolution Optimization
- Telecommunication Systems Efficiency
- Billing and payment issue resolution
- Customer satisfaction analysis
- Automobile claim handling
- Insurance contract interpretation
- Multilingual client support
- Coverage determination
- Third-party vendor management
- Policyholder communication
- Fraud Detection and Prevention
- High-value claims processing
- Health insurance claims handling
- Advanced reporting and analytics
- Medical claims coordination
- Claims Auditing
- Document review and verification
- HIPPA
- Analysis Skills
- Organizational Skills
- Technical Support
- Microsoft Excel
- Microsoft Word
- Microsoft office
- Quality Assurance
- Multi-Line Phone system
- Typing
- Medical terminology
- EMR Systems
- IC10 codes
- Claims
- Claim processing
- Patient support
- Claims auditing
- Regulatory compliance
Timeline
Claim Processor
Athena Consulting Llc
08.2025 - 03.2026
Patient Service Representative / Claim Processor ( Hybrid)
Advanced Radiology | Aiello Center at BWMC
02.2023 - 02.2025
Healthcare Claim Rep (Remote)
John Hopkins Health LLC
11.2019 - 12.2022
Financial Services Representative
S3 Shared Service Solutions
03.2017 - 10.2019
Patient Service Representative
Call 4 Health
06.2014 - 09.2016
High School -
Walbrook High School