Diplomatic Customer Service Professional experienced in analyzing customer requests and resolving issues efficiently. Achieved improved efficiency in claim processing through strong analytical skills and exceptional communication abilities. Focused on delivering superior service while managing complete claims processes with minimal direction.
Overview
13
13
years of professional experience
Work History
SENIOR LTC CLAIMS REPRESENTATIVE
Genworth Financial
Lynchburg, VA
02.2023 - Current
Processed high volume of claims efficiently, ensuring adherence to quality standards.
Processed claims efficiently and accurately for various insurance products.
Reviewed documentation for compliance with company policies and regulations to uphold integrity.
Analyzed claim data to identify trends and potential issues proactively.
Collaborated with internal teams to enhance claims processing workflows.
Maintained up-to-date knowledge of industry changes impacting claims management.
Communicated with clients to resolve inquiries and provide timely updates on claims status.
Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.
Handled customer inquiries regarding insurance policy coverage details and payment status updates.
Documented claim decisions clearly in the company database for future reference.
Institutional Review Board Member
Advarra
Lynchburg, VA
07.2022 - Current
Ensure safe gene therapy research & efficient study startup with responsive institutional biosafety committee review and support services.
Conducted board meetings and prepared agendas to facilitate decision-making and ensure compliance.
Attended board meetings and reviewed meeting agendas.
Reviewed audit results from external auditors and resolved identified issues to enhance regulatory adherence.
Assessed investment options to evaluate potential risks and rewards, informing strategic investment decisions. for potential risks and rewards.
Provider Services Representative
Evolent Heath
Arlington, VA
11.2022 - 08.2024
Resolved customer complaints, escalating complex issues to senior staff for timely resolution.
Processed prior authorization requests for medical services, ensuring compliance with policy requirements.
Performed data entry tasks including entering patient information into electronic medical records systems.
Answered incoming calls from clients and routed them to appropriate personnel for further assistance.
Adhered to all applicable laws, regulations, standards, and procedures when interacting with customers and providers.
Verified accuracy of submitted documentation, facilitating smooth processing of claims and services.
Remote customer service representative
Inbound calls
Customer excellence
Back office work
Appeals
Diagnostic imaging
Phlebotomy Technician
LabCorp
Richmond, VA
05.2021 - 10.2021
Phlebotomist
Performed venipuncture and skin puncture on patients of all ages.
Obtained specimens from adults, children, and infants for laboratory tests.
Collected blood samples in a safe and sanitary manner according to established procedures.
Labeled specimen containers with patient information accurately and legibly.
Maintained and sterilized equipment to uphold safety standards and ensure patient safety.
Organized and maintained accurate records of specimens and test results for improved lab tracking.
Verified patient identification prior to collection of specimens using two forms of ID verification.
Conducted quality control checks on equipment regularly.
Adhered to HIPAA regulations while maintaining confidentiality of patient information.
Streamlined patient registration process to enhance workflow efficiency.
Medicaid eligibility
Clerical duties
Scheduling
Billing support
Coding
Phlebotomy Supervisor
American Red Cross Blood Services
Richmond, VA
04.2016 - 10.2020
Developed and maintained phlebotomy procedures to ensure compliance with regulations and enhance patient safety.
Trained and supervised phlebotomists and lab assistants.
Provided training for new employees on safety protocols, specimen collection techniques, proper documentation methods and HIPAA requirements.
Coordinated workflow between lab technicians and departments to optimize specimen processing and reduce turnaround time.
Ensured accuracy of test results by performing quality assurance checks on equipment and personnel competency.
Identified risks in phlebotomy activities and implemented mitigation strategies to improve operational safety.
Managed staffing and scheduling of phlebotomy lab personnel.
Maintained a clean work environment by enforcing safety policies and adhering to OSHA guidelines.
Assisted in resolving customer complaints regarding specimen collection services or inaccurate test results.
Oversaw blood drives to ensure efficient operations and adherence to safety protocols.
Phlebotomy
Vitals
Clinical
Documentation
Packing and shipping
Care Partner
Medical Assistant
NeuroCare of Virginia
Prince George, VA
10.2015 - 03.2016
Provided patient support and assistance through essential CNA tasks to enhance patient comfort and care.
Registration
Night
Assisted physicians with patient care by taking vital signs, patient histories and preparing patients for examinations.
Administered injections, medications, and treatments per physician instructions.
Provided assistance to medical staff in performing minor surgical procedures.
Maintained accurate medical records through filing, charting, transcription and data entry into electronic health record system.
Managed patient flow by answering phones, scheduling appointments, and greeting visitors professionally to ensure efficient clinic operations.
Educated patients on nutrition and disease prevention to promote health awareness and informed decision-making.
Medical Assistant
Colonial Heights Pediatrics
Colonial Heights, VA
10.2014 - 02.2016
Coordinated delivery of specialized treatments and therapies for pediatric patients, ensuring timely and effective care.
Facilitated coordination of pediatric care services among multiple departments and physicians to enhance patient outcomes.
Developed effective relationships with families to ensure quality care for their children.
Supported medical staff with administrative tasks, streamlining appointment scheduling and record maintenance.
CNA
VCU Health
Richmond, VA
10.2014 - 01.2016
Injections
Phlebotomy
Registration
Processed insurance claims for General Dynamics, ensuring accuracy and compliance with regulations
Verified insurance coverage to confirm eligibility and facilitate patient access to necessary services
Negotiated settlements to achieve favorable outcomes for clients while adhering to industry standards
Reviewed insurance cases to ensure compliance with regulations and accuracy of information.
Coding
Waitress
Westminster Canterbury-Richmond
Richmond, VA
04.2013 - 12.2014
Took orders for food and drinks and delivered them to guests.
Checked back with customers during meal service to ensure satisfaction and address any concerns.
Greeted customers warmly and provided menus to facilitate a pleasant dining experience.
Assisted in seating guests at tables or booths.
Refilled beverages for guests during meal service.
Answered questions about menu items, ingredients, and pricing to assist customers in making informed choices.