NaTosha Dudley
Cincinnati
Summary
Experienced and driven Claims Representative with a passion for helping others. Professional experience includes customer service, claims processing and handling, claim file management, data reporting, quality control, risk management, and compliance. Top skills include complex problem solving, customer service, data quality, file reporting, organization, and multi-tasking. 10+ years of Customer Service Experience, 2 years of Claims processing/handling and file reporting experience, B.S degree in Healthcare Administration.
Overview
9
9
years of professional experience
Work History
Claims Representative
Great American Insurance Group
01.2023 - Current
- Worked productively in fast-moving work environment to process large volumes of moderate and complex claims (80+ pending).
- Updated claims system to track claim status and provide relevant information to other department.
- Communicated effectively with staff members of operations, finance and claims departments.
- Examined reports, accounts, and evidence to determine integrity and accuracy of information.
- Developed and implemented strategies to improve claim processes.
- Prepared and presented detailed reports to management on claims issues to aid in decision making.
- Loss adjustments for high value claims.
- Quality control and audit tracking to maintain policy compliant.
Senior Commercial Claims Processing Technician
Great American Insurance Group
10.2021 - Current
- Sets up claims files
- Files correspondence and other material related to claims records, as directed
- Updates claims files and maintains, corrects, and/or updates data using office technology.
- Answers incoming phone calls and responds to inquiries and gathers information
- Locates policies
- Obtains coverage information from policies
- Investigates discrepancies in information gathered
- Enters information into system(s)
- Orders reports
- Pulls files
- Reviews data and text associated with claims files
Healthcare Practice Manager Internship
The Christ Hospital M.D V.I.P
01.2021 - 04.2021
- Oversaw fiscal operations, including accounting, budgeting, authorizing expenditures and financial reporting.
- Assisted with regulatory issues such as compliance.
- Provided outstanding support to entire staff which helped improve process flow and boosted efficiency.
- Created and implemented organizational policies and procedures.
- Developed policies and procedures for effective practice management.
- Addressed and remedied all patient or team member issues.
- Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
Payment Processor
Fifth Third Bank
06.2017 - 10.2021
- Performed administrative and clerical tasks by entering data, preparing invoices and filing paperwork.
- Used RPS software to generate financial statements and reports.
- Utilized ITRAN check extracting/imaging machine.
- Balanced check amounts with backup documentation.
- Data Entry
Lead Accessories Sales Associate
Burlington
09.2016 - 10.2017
- Kept Accessories department area clean, tidy and professional in appearance to maximize worker efficiency and promote customer engagement.
- Opened, shelved and merchandised new products in visually appealing and organized displays for optimal sales promotions.
- Listened to customer needs and desires to identify and recommend optimal products.
- Managed efficient cash register operations, including scanning items, processing payments and issuing receipts.
Data Entry Clerk
RandstadUSA Temp Agency (US BANK Lockbox)
03.2016 - 12.2016
- Performed 10-key actions while maintaining 0% error rate.
- Entered numerical data into databases with speed and accuracy using 10-key pad.
- Client checking account balancing.
- Data Entry
Shift Supervisor/Pharmacy Technician Trainee
CVS Health
03.2015 - 06.2016
- Communicated with prescribers to verify medication dosages, refill authorizations and patient information.
- Reviewed and verified customer information and insurance provider information.
- Communicated with patients to collect information about prescriptions and medical conditions or arrange consultations with pharmacists.
- Counted, measured, and compounded medications following standard procedures.
- Maintained clean and well-organized production areas to avoid violations or unnecessary work delays due to hazards or inefficient layouts.
- Completed store opening and closing procedures, including setting up registers and checking products.
- Responded to and resolved customer questions and concerns.
Education
Bachelor of Science - Health Administration
The Christ College of Nursing And Health Sciences
Cincinnati, OH05.2021
No Degree - Medical Assisting /Billing And Coding (2014-2018)
The University of Cincinnati
Cincinnati OhioSkills
- Customer Service
- Multitasking
- Microsoft applications (outlook, word , excel, powerpoint)
- Professional Communication (written and verbal)
- HIPAA and Confidentiality Compliance
- Risk Management and Regulating
- Claims Processing
- Attention to Detail
- Time Management
- Data Analysis
- Recordkeeping
- Documentation and reporting
- Customer Relations
- File reporting
- Loss Adjusting
Affiliations
- ACHE - American College of Healthcare Executives
- NAAIA - National African American Insurance Association
https://www.linkedin.com/in/natosha-dudley-2918a6126/
Timeline
Claims Representative
Great American Insurance Group
01.2023 - Current
Senior Commercial Claims Processing Technician
Great American Insurance Group
10.2021 - Current
Healthcare Practice Manager Internship
The Christ Hospital M.D V.I.P
01.2021 - 04.2021
Payment Processor
Fifth Third Bank
06.2017 - 10.2021
Lead Accessories Sales Associate
Burlington
09.2016 - 10.2017
Data Entry Clerk
RandstadUSA Temp Agency (US BANK Lockbox)
03.2016 - 12.2016
Shift Supervisor/Pharmacy Technician Trainee
CVS Health
03.2015 - 06.2016
Bachelor of Science - Health Administration
The Christ College of Nursing And Health Sciences
No Degree - Medical Assisting /Billing And Coding (2014-2018)
The University of Cincinnati
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