N'DIA CHAMBERS
Paterson,USA
Summary
Detail-oriented health insurance professional with experience in claims review, member support, and benefits analysis within a managed care environment. Skilled in investigating discrepancies, resolving complex member issues, and ensuring compliance with PPO/HMO and Medicare guidelines. Proven ability to analyze trends, support appeals processes, and deliver accurate, timely resolutions.
Overview
5
5
years of professional experience
Work History
Call Center Representative
Horizon BCBSNJ
Newark, New Jersey
08.2024 - Current
- Review and analyze member claims, benefits, and eligibility across multiple systems to ensure accurate and compliant resolutions
- Investigate and resolve complex member complaints related to claims processing, billing discrepancies, and coverage determinations
- Provide real-time support to members through chat and phone channels, delivering clear, accurate, and timely responses
- Manage multiple chat interactions simultaneously while maintaining high-quality service and attention to detail
- Identify patterns in member inquiries and contribute insights to improve service quality and operational efficiency
- Collaborate with internal departments to research and escalate issues requiring further review or adjustment
- Maintain strict adherence to HIPAA and company policies when handling sensitive member information
Clerk/Typist
Office of the Public Defender
Paterson, New Jersey
03.2023 - 08.2024
- Performed data entry, document preparation, and records management with a high level of accuracy
- Assisted in preparing legal documents and case files, ensuring compliance with court standards
- Maintained confidential information and supported administrative operations efficiently
Data Collection Specialist
United States Post Office
Teterboro, New Jersey
08.2021 - 03.2023
- Collected, reviewed, and analyzed operational data to ensure accuracy in reporting
- Identified trends and recommended process improvements based on data findings
- Maintained detailed and organized records to support operational decision-making
Education
No Degree - Sociology
Morgan State University
Baltimore, MDHigh School Diploma -
John F. Kennedy Educational High School
Paterson, NJ06.2018
Skills
- Claims Investigation & Review
- Appeals & Grievance Support
- Coordination of Benefits (COB)
- Medicare & Commercial Plan Knowledge
- HIPAA & Compliance
- Data Analysis & Trend Identification
- Customer Issue Resolution
- Live Chat & Multichannel Support
- Written Communication & Real-Time Chat Handling
- Microsoft Excel & Office Suite
- ITS & BlueCard Systems
Timeline
Call Center Representative
Horizon BCBSNJ
08.2024 - Current
Clerk/Typist
Office of the Public Defender
03.2023 - 08.2024
Data Collection Specialist
United States Post Office
08.2021 - 03.2023
No Degree - Sociology
Morgan State University
High School Diploma -
John F. Kennedy Educational High School