Nija Simpson
Charlotte,NC
Summary
Results-driven healthcare operations professional with over 8 years in insurance verification, benefits administration, and member support. Expertise in processing insurance information, resolving complex inquiries, and maintaining compliance with HIPAA standards. Proven ability to communicate effectively with stakeholders, manage multiple priorities, and adapt to new claims processes. Ready to leverage skills in a workers’ compensation claims professional training program.
Overview
11
11
years of professional experience
Work History
Patient Access Specialist
Cencora
Fort Mill, SC
07.2018 - 03.2026
- Perform insurance benefit verification to determine coverage and prior authorization status.
- Maintain compliance with HIPAA regulations while handling sensitive medical and insurance information.
- Managed high-volume call environment while maintaining accuracy, efficiency, and quality standards.
- Resolve customer issues by asking detailed probing questions and identifying appropriate solutions during first-contact interactions.
- Communicating effectively with insured patients, medical providers, payers and carrier representatives primarily through telephonic.
- Processing and responding to incoming calls, emails, and other related documents according to the status of enrollment in a remote environment.
- Document customer interactions, updates, and benefit changes accurately across multiple systems.
- De-escalate challenging customer situations through active listening, empathy, and solution-focused communication.
- Participated in virtual and in-person meetings to enhance team collaboration and communication.
Sales Agent
Concentrix
Charlotte, NC
11.2016 - 07.2018
- Provided professional customer support while educating customers on OnStar services and available plans.
- Follow company procedures and sales guidelines to complete compliant transactions.
- Updated customer accounts, processed payments, and maintained accurate account documentation.
- Addressed customer questions and concerns while building rapport and delivering personalized solutions.
- Utilized active listening skills to identify customer needs and recommend appropriate services.
Cashier / Merchandise Associate
Walmart
Charlotte, NC
07.2016 - 11.2016
- Delivered friendly and efficient customer service while assisting customers with purchases and inquiries.
- Maintained accurate checkout transactions and handled customer payments.
- Assisted customers with product questions and provided recommendations.
- Supported inventory organization, stocking, and merchandise presentation.
- Followed company policies related to loss prevention and operational procedures.
Jr. Agent
iQor
Charlotte, NC
09.2015 - 05.2016
- Assisted customers with healthcare billing questions and explained insurance-related information.
- Provided support for medical billing inquiries and customer account concerns.
- Processed payments and updated customer accounts accurately.
- Handled policy terminations and reinstatements while following company procedures.
Education
High School Diploma -
Garinger High School
Charlotte, NC06-2015
Skills
- Benefits administration
- Strong Communicator
- HIPAA compliance
- Customer service
- Problem resolution
- Multi-Tasker
- Structural Thinker
- Spreadsheet documentation
- Deadline management
- Team leadership
- Agile Learner
- Strong Attention to Detail
Languages
English
Timeline
Patient Access Specialist
Cencora
07.2018 - 03.2026
Sales Agent
Concentrix
11.2016 - 07.2018
Cashier / Merchandise Associate
Walmart
07.2016 - 11.2016
Jr. Agent
iQor
09.2015 - 05.2016
High School Diploma -
Garinger High School