Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
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Nicole Ragland

Thomaston,GA

Summary

Healthcare Claims Resolution Consultant Dedicated and detail-oriented professional with extensive experience in claims resolution, customer service, and compliance. Proficient in analyzing appeals, auditing, and delivering expert guidance in coding and medical policy interpretation. Skilled in navigating healthcare claims systems, collaborating with teams, and driving performance improvements. Passionate about advancing health equity and improving patient outcomes through meticulous review processes and strategic problem-solving.

Overview

7
7
years of professional experience

Work History

Payroll Tech Support

Alorica
07.2023 - Current
  • Proactively addressed payroll inquiries, including discrepancies in tax withholdings and benefit deductions, ensuring a 100% resolution rate for Tier 2 support
  • Maintained accurate documentation of payroll issues for auditing purposes, adhering to strict confidentiality standards
  • Delivered training resources to improve user understanding of payroll systems, showcasing strong coaching and educational abilities

Customer Service Representative

Phillip Bell State Farm
Thomaston, USA
12.2022 - 05.2023
  • Analyzed client needs and provided tailored insurance solutions, leveraging CRM tools for efficient claim processing
  • Built strong client relationships through attentive communication and prompt issue resolution, enhancing client loyalty
  • Strengthened field proficiency by acquiring Property & Casualty and Life & Health licenses

Customer Service Representative

Geico
Macon, USA
06.2022 - 12.2022
  • Utilized coding expertise to support accurate insurance claims processing and resolution
  • Demonstrated regulatory compliance by adhering to insurance industry standards and policies
  • Resolved client inquiries effectively, maintaining a professional and empathetic demeanor

Customer Service Representative

Carvana
Dunwoody, USA
04.2022 - 05.2022
  • Fostered collaboration across teams to address complex customer concerns, ensuring seamless resolutions
  • Maintained exceptional service quality, managing high volumes of inquiries with efficiency and professionalism

Customer Service Representative

The Home Depot
Thomaston, USA
02.2018 - 03.2022
  • Successfully managed customer complaints and inquiries, demonstrating strong problem-solving capabilities
  • Streamlined processes for returns, orders, and exchanges, enhancing customer satisfaction
  • Consistently met and exceeded daily service targets while maintaining a focus on quality

Education

Diploma in Dental Assisting -

UEI College

High School Diploma -

Upson-Lee High School

Skills

  • Medical Records Review & Appeals
  • CPT-4 Coding
  • NCCI Edit Resolution
  • Regulatory Compliance
  • Risk Assessment
  • Claims Investigation
  • Overpayment Analysis
  • Effective Written Communication
  • Effective Verbal Communication
  • Cross-Team Collaboration
  • Training
  • Data Analysis
  • Reporting
  • CRM Software Proficiency
  • Salesforce
  • Microsoft Office Suite
  • Adobe
  • Technical Skills
  • Data Analysis and Reporting Tools

Accomplishments

  • Consistently maintained a high resolution rate for claims and appeals, leveraging analytical and coding expertise to ensure accuracy.
  • Spearheaded training initiatives, improving team efficiency and knowledge retention.
  • Recognized for exemplary performance in resolving complex customer concerns and maintaining compliance with healthcare and insurance regulations.

Timeline

Payroll Tech Support

Alorica
07.2023 - Current

Customer Service Representative

Phillip Bell State Farm
12.2022 - 05.2023

Customer Service Representative

Geico
06.2022 - 12.2022

Customer Service Representative

Carvana
04.2022 - 05.2022

Customer Service Representative

The Home Depot
02.2018 - 03.2022

Diploma in Dental Assisting -

UEI College

High School Diploma -

Upson-Lee High School

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Nicole Ragland