Pamela Berger
Summary
Energetically driven and detail-oriented, I excel in fast-paced environments, evidenced by my tenure at SunLife/Dentaquest. My expertise in appeals management and claims processing, alongside a commitment to teamwork and problem-solving, has consistently exceeded performance metrics. With a strong foundation in medical terminology and a reputation for dependability, I am poised to deliver exceptional results.
Overview
21
21
years of professional experience
Work History
Customer Service for Calls
SunLife/Dentaquest
05.2024 - Current
- Working effectively in fast-paced environments.
- Organized and detail-oriented with a strong work ethic.
- Proven ability to learn quickly and adapt to new situations, and software.
Appeals Team
Sunlife
05.2015 - 05.2024
- Managed all situations with professionalism, ensuring that appeals were handled promptly and accurately even under tight deadlines or heavy caseloads for 8 states.
- Consistently met or exceeded performance metrics, demonstrating a strong understanding of the claims review process and an unwavering commitment to achieving positive results for clients.
- Achieved successful appeal outcomes by meticulously reviewing and analyzing claim denials and identifying errors.
- Expedited resolution times for appeals cases by efficiently managing workload and prioritizing urgent matters.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Maintained confidentiality of patient records, and health statuses.
- Managed multiple priorities simultaneously while maintaining attention to detail and meeting deadlines under pressure.
Representative for Calls and Claims Processing
Fortus, Assurant and Sunlife
08.2004 - 06.2015
- Took a variety of calls which included but dedicated and easey start calls.
- Achieved high levels of accuracy and consistency in claims processing through diligent attention to detail and a commitment to continuous improvement.
- Handled high volume of daily claims while consistently meeting deadlines and maintaining attention to detail.
- Maintained confidentiality of patient finances, records, and health statuses.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Responded to customer inquiries, providing detailed explanations of insurance policies and claims processes.
- Actively participated in team meetings and training sessions, contributing valuable insights and staying current on best practices in the industry.
Customer Service Representative
Delta Dental
04.2003 - 05.2004
- Participated in training programs to enhance product knowledge and customer service skills.
- Maintained detailed records of customer interactions and transactions, ensuring accurate documentation and follow-up.
Education
Loop Community College
Chicago, ILHigh School Diploma -
St. Marys
Chicago, IL05.1975
Skills
- Friendly, Positive Attitude
- Teamwork and Collaboration
- Problem-Solving
- Dependable and Responsible
Timeline
Customer Service for Calls
SunLife/Dentaquest
05.2024 - Current
Appeals Team
Sunlife
05.2015 - 05.2024
Representative for Calls and Claims Processing
Fortus, Assurant and Sunlife
08.2004 - 06.2015
Customer Service Representative
Delta Dental
04.2003 - 05.2004
Loop Community College
High School Diploma -
St. Marys
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