Quanda Gibson
Lutz,FL
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
18
18
years of professional experience
Work History
Contact Center Agent
Epiq
12.2023 - 03.2024
- Answered telephone inquiries on banking inquiries
- Effectively managed a high-volume and inbound and outbound customer calls
- Maintained high call quality standards by adhering to company policies and procedures for each interaction
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
Billing Specialist
Amgen
04.2023 - 09.2023
- Precisely completed appropriate claims paperwork, documentation and system entry
- Audited and corrected billing and posting documents for accuracy
- Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures
Contact Center Reservations Agent
Air Canada
10.2022 - 01.2023
- Managed high call volume with exceptional attention to detail, resulting in fewer booking errors and cancellations
- Handled billing information over phone
- Provided customers with information about availability and pricing
- Provided high level of customer service to each person by engaging customer and using active listening and effective interpersonal skills
- Processed payments securely while adhering to strict confidentiality guidelines regarding personal financial information
Billing Specialist
WellCare/ Centene
08.2021 - 09.2022
- Efficiently operate in a contact center environment and navigate multiple systems and programs while maintaining an engaging member interaction that may occur across multiple channels
- Researched and resolved billing discrepancies to enable accurate billing
- Answer, resolve, track and document inbound/outbound calls from members and providers by engaging in active listening confirming or clarifying information and deescalating situations as necessary
- Processes the setup of direct debit for premium billing
- Referred unresolved customer grievances to designated department for further investigations
Provider Data Management Analyst
WellCare/ Centene
06.2018 - 09.2021
- Ability to prioritize and multi-task, while navigating through multiple business applications
- General understanding and knowledge of the Center for Medicare and Medicaid Systems
- Resolve medical claims by approving or denying documentation, calculating benefits due, composing a denial response
- Processing medical claims
- Enter claim data accurately and timely, in alignment with departmental production and quality goals
- Maintain a minimum of 98% accuracy at all times
- Following HIPPA guidance privacy / law
Configuration Data Specialist
WellCare/ Centene
12.2015 - 06.2018
- Ability to problem solve and make decisions
- Demonstrated attention to detail and accuracy
- Excellent database and Internet navigating skills
- Ability to meet strict deadlines
- Educate providers on billing requirements to reduce claim submission rejections/ denials
- Met or Exceeded service and quality standards every review period
Care Coordinator
WellCare Healthplans
04.2012 - 12.2015
- Provides administrative support to ensure efficient operation of the office
- Strong communicator works well independently and with a team
- Proficient in coordinating medical cases, managing patient information, and liaising with healthcare providers to ensure seamless care delivery
- Provide / Explain benefits information to members/ providers
Member Engagement Specialist
Wellcare Healthplans
05.2010 - 04.2012
- Strong problem-solving and critical thinking abilities to assess patients' needs, identify potential barriers, and develop effective discharge plans
- Work collaboratively in a team environment, contributing to team goals and supporting colleagues
- Completes comprehensive assessments, assessing the total needs of the client . Maintain patient records and update information as necessary
- Excellent communication and interpersonal skills.
Intake Authorization Specialist
WellCare Healthplans
08.2006 - 04.2010
- Knowledge of medical terminology and procedures
- Refer claims for medical management claim review as necessary/applicable
- Educate providers on prior authorization requirements.
Education
Associate of Science Business Administration -
Hillsborough Community College
Tampa, FLHigh School Diploma -
North Miami Senior High School
North Miami, FLSkills
- Claims handling, knowledge of medical insurance and authorization processes
- Knowledge and skills working in computerized billing systems
- Medical terminology and experience working in a healthcare and insurance environment
- Good written and oral communications
- Customer Relationship Management
- Attention to detail and accuracy
- Computer and typing skills
- Proficiency with MS Office applications (Excel word processing, database/spreadsheet)
- Account Reconciliation
- Remittance Management
- Credit card processing
- Data Entry
Timeline
Contact Center Agent
Epiq
12.2023 - 03.2024
Billing Specialist
Amgen
04.2023 - 09.2023
Contact Center Reservations Agent
Air Canada
10.2022 - 01.2023
Billing Specialist
WellCare/ Centene
08.2021 - 09.2022
Provider Data Management Analyst
WellCare/ Centene
06.2018 - 09.2021
Configuration Data Specialist
WellCare/ Centene
12.2015 - 06.2018
Care Coordinator
WellCare Healthplans
04.2012 - 12.2015
Member Engagement Specialist
Wellcare Healthplans
05.2010 - 04.2012
Intake Authorization Specialist
WellCare Healthplans
08.2006 - 04.2010
Associate of Science Business Administration -
Hillsborough Community College
High School Diploma -
North Miami Senior High School
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