Maintained comprehensive database for enrollment data, claim submission and payment information.
Processed claims according to established quality and production standards and made corrections and adjustments to solve problems.
Checked documentation for appropriate coding, catching errors and making revisions.
Accurately processed large volume of medical claims every shift.
Used contract notes and processing manual to correctly apply group-specific classifications to claims.
Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
Evaluated pending claims to identify and resolve problems blocking auto-adjudication.
Reviewed claims for accuracy before submitting for billing.
Participated in new hire training and development tasks.
Technical Support Specialist
Tandem Diabetes Care Inc.
03.2019 - 04.2020
Able to troubleshoot a high-tech insulin pump for insulin delivery and continuous glucose monitoring integration.
Responsible for all documentation of issues and allegations being reported by a customer.
Consulted via telephone to understand user problems, run through testing scripts and ask probing questions to locate root causes.
Received inbound phone calls from customers to provide first-level support and remotely troubleshoot issues with service, equipment or customer accounts.
Barback
Botaia Winery
08.2018 - 10.2018
Updated company databases with inventory requests
Kept winery clean to meet company standards
Lift and move items (20-30 pounds) to help servers with future duties
Responsible for wine inventory at the end of every shift
Bust and prepare tables for future guests.
Barista
Perks Coffee House
03.2018 - 03.2019
Made enjoyable coffee and food; also prepped food for future orders.
Handle frontline registers and took orders over the phone for future orders.
Kept café clean to meet company standards.
Complete inbound calls for orders and updating inventory items with the manager.
Shift Leader
Witch Creek Winery
12.2016 - 06.2018
Increased membership sales by explaining in full detail what our membership includes
Coordinated events/parties for wine club members
Responsible for food and wine inventory
Handled frontline register and answered phone calls to assist any guests with questions or concerns
Kept winery clean to meet company standards.
Education
Bachelor of Science in Kinesiology - Health Science
California State University San Marcos
San Marcos, California
06.2018
Skills
Quality Assurance
Root Cause Analysis
Customer Relations
Experience in leadership
Process Improvement
Timeline
Quality Review Specialist, Lead
Tandem Diabetes Care Inc.
04.2024 - Current
Technical Support Specialist
Tandem Diabetes Care Inc.
03.2019 - 04.2020
Barback
Botaia Winery
08.2018 - 10.2018
Barista
Perks Coffee House
03.2018 - 03.2019
Shift Leader
Witch Creek Winery
12.2016 - 06.2018
Bachelor of Science in Kinesiology - Health Science