Patricia Brown
Richmond,United States
Summary
Diligent Claims Processor versed in insurance processes and claims procedures. Offers great attention to detail and time management abilities to successfully handle large volumes of claims. Highly accurate and thorough with focus on completing error-free work in line with processing guidelines.
Overview
10
10
years of professional experience
Work History
Licensed Insurance Producer
Independent Insurance Agent
Remote, Texas
01.2013 - 04.2023
- Performed needs analysis to obtain information required to make appropriate health insurance product recommendations.
- Contacted insurance companies to discuss and resolve unpaid claims and incorrectly paid claims.
- Answered inbound calls from existing and future policyholders to answer inquiries and discuss insurance options.
- Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
- Developed sales leads from direct referrals, networking and targeted marketing campaigns.
- Generated leads through cold-calling, networking and other outreach methods.
- Analyzed customer needs to provide customized insurance solutions.
- Educated clients on insurance policies and procedures.
Claims Representative
Hagerty Insurance
Remote, Texas
02.2022 - 01.2023
- Interviewed policyholders to verify information and obtain additional details.
- Examined reports, accounts, and evidence to determine integrity and accuracy of information.
- Followed up with customers on unresolved issues.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Collaborated with internal departments and external vendors to achieve fast resolution of claims.
- Verified client information by analyzing existing evidence on file.
Clinical Administrative Coordinator
UnitedHealth Group
Remote, Texas
08.2018 - 04.2022
- Reviewed cases to determine need for escalation.
- Maintained complete documentation for permanent records and auditing purposes.
- Provided comprehensive administrative support to department staff.
- Maintained knowledge of standardized medical billing codes.
- Met all confidentiality guidelines as directed by company.
- Demonstrated confidentiality in dealing with sensitive information or records to comply with HIPAA guidelines and regulations.
- Verified medical terminology and codes to deliver accurate and up-to-date information.
- Communicated with healthcare providers to clarify information and resolve issues.
Provider's Claims Representative
UnitedHealth Group
Remote, TX
08.2017 - 08.2018
- Worked productively in thefast-moving work environment to process large volumes of claims.
- Interviewed policyholders to verify information and obtain additional details.
- Examined reports, accounts, and evidence to determine integrity and accuracy of information.
- Followed up with customers on unresolved issues.
- Researched and analyzed complex claims to determine next steps and possible outcomes.
- Responded to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility, and claims.
Education
Bachelor of Science - Psychology And Business Administration
Central Michigan University
Mt. Pleasant, MISkills
- Policy management
- Client Service
- Contract review and analysis
- Product knowledge
- Data security procedures
- Documentation abilities
- Thorough claims reviews
- Report analysis
- Medical terminology
- Maintains confidentiality
- Proofreading
- Research Reporting
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
The mind is everything. What you think, you become.
Gautama Buddha
Timeline
Claims Representative
Hagerty Insurance
02.2022 - 01.2023
Clinical Administrative Coordinator
UnitedHealth Group
08.2018 - 04.2022
Provider's Claims Representative
UnitedHealth Group
08.2017 - 08.2018
Licensed Insurance Producer
Independent Insurance Agent
01.2013 - 04.2023
Bachelor of Science - Psychology And Business Administration
Central Michigan University
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