
Results-driven claims processing professional with strong skills in medical billing support and HIPAA compliance. Committed to enhancing member satisfaction through effective problem-solving and communication.
• Provided customer service for members with health and pharmacy plans in a high-volume call center environment.
• Handled benefit, eligibility, claims, billing, pharmacy, and financial account inquiries.
• Processed and adjusted medical claims while reviewing benefits, billing, and eligibility for accurate resolution.
• Assisted with provider payments, coverage questions, appointment scheduling, and billing concerns.
• Researched complex issues across multiple systems and coordinated with internal teams and vendors for resolution.
• Educated members on plan benefits and self-service tools while meeting goals for call quality, efficiency, attendance, and member satisfaction.
• Assisted members with benefits enrollment, eligibility, claims, and healthcare service inquiries.
• Resolved customer concerns with a focus on first-call resolution and member satisfaction.
• Contacted providers regarding appointments, billing concerns, and claims resolution.
• Coordinated with internal departments to resolve complex member issues efficiently.
• Educated members on benefits and healthcare resources to support informed decisions.
• Performed identity verification and enrollment services for TSA PreCheck applicants through IDEMIA.
• Reviewed documentation, verified identity information, and captured fingerprints and photographs.
• Ensured application accuracy while maintaining compliance with federal security and privacy regulations.
• Educated applicants on TSA PreCheck procedures, requirements, and status updates.
• Processed payments, handled sensitive information confidentially, and maintained accurate records.
• Provided clinical and administrative support in a fast-paced urgent care setting.
• Assisted with patient intake, vital signs, medical histories, and exam preparation.
• Supported providers during examinations and treatments while ensuring quality patient care.
• Administered injections, performed basic laboratory testing, and maintained patient records.
• Scheduled appointments, verified insurance, and answered patient questions.
• Maintained cleanliness and organization of exam rooms and medical equipment in compliance with safety standards.
Claims Processing & Adjustments
Benefits & Eligibility Verification
Medical Billing Support
Call Center Operations
Insurance Verification
Medical Terminology
HIPAA Compliance
Electronic Medical Records (EMR)
Problem Solving
Data Entry & Documentation
Multitasking
Provider Relations
Microsoft Office Suite
Communication Skills
Time Management