Nydir Bethea
Sharon Hill,PA
Summary
Customer Service Professional with expertise in coordinating patient care and enhancing communication between healthcare providers and patients. Proven problem-solving skills and adaptability have led to improved patient experiences and satisfaction. Achievements include streamlining administrative processes and increasing operational efficiency across various healthcare environments. Focused on advancing skills in patient advocacy and service excellence.
Overview
7
7
years of professional experience
Work History
Insurance Verification Specialist
Florida Blue- Blue Cross Blue Shield
Remote, PA
08.2022 - 09.2025
- Verified insurance benefits prior to patient procedures and appointments to ensure timely coverage.
- Updated patient records with accurate insurance policy information for effective management.
- Interacted with insurance carriers to clarify policies and individual patient benefits.
- Adhered to HIPAA guidelines to protect confidential patient data.
- Maintained comprehensive understanding of medical terminology to enhance communication about services.
- Resolved patient inquiries regarding insurance coverage and billing, boosting satisfaction levels.
Pharmacy Customer Service Representative
Convergys
Middletown, PA
11.2020 - 08.2022
- Facilitated navigation of insurance claims, reducing denials and enhancing coverage comprehension.
- Demonstrated adaptability through cross-training in multiple pharmacy roles to improve customer service.
- Collaborated with pharmacists to address drug therapy issues, improving patient health outcomes.
Claims Specialist
Sedgwick
Remote, PA
06.2018 - 11.2020
- Increased customer satisfaction via prompt and empathetic communication about claim outcomes.
- Organized and prioritized tasks to manage a high volume of claims efficiently.
- Utilized critical thinking and negotiation skills to settle complex claims fairly.
- Displayed professionalism during high-pressure situations, resulting in favorable client outcomes.
- Ensured resolution of outstanding issues through consistent follow-up actions.
- Decreased processing errors by thoroughly investigating claims and accurately interpreting policies.
Education
High School - undefined
Penn Foster High School
Scranton, PA05.2022
Skills
- CPT and ICD-9 coding
- Insurance billing and verification
- Compliance with HIPAA regulations
- Terminology in healthcare
- Management of electronic medical records (EMR)
- Proficient in Microsoft Office Suite
- Salesforce CRM skills
- Processing payments efficiently
- Handling inbound and outbound
- Knowledge of medical insurance policies
- Understanding Medicare Parts A, B, and C
- Expertise in customer relationship management (CRM)
- Data entry accuracy and verification processes
- Claims management expertise
- Building patient rapport effectively
- Excellence in customer service delivery
- CPT coding
- Insurance verification
- Medical terminology
Timeline
Insurance Verification Specialist
Florida Blue- Blue Cross Blue Shield
08.2022 - 09.2025
Pharmacy Customer Service Representative
Convergys
11.2020 - 08.2022
Claims Specialist
Sedgwick
06.2018 - 11.2020
High School - undefined
Penn Foster High School