Summary
Overview
Work History
Education
Skills
Software
Timeline
Generic

Regina Carter

Little Elm,TX

Summary

With over 10 years of customer service experience, including 8 years in the healthcare insurance industry, this professional brings a strong background in providing exceptional service and efficiently managing critical information. Their expertise lies in ensuring accuracy and attention to detail in all aspects of their work. They are well-versed in the intricacies of the healthcare industry, combining their customer service skills with their data entry proficiency. Dedicated to delivering top-notch support, they are committed to contributing to the success of any organization.

Overview

7
7
years of professional experience

Work History

Care Coordination Specialist

Signify Health
11.2024 - Current
  • Coordinate care services by collaborating with healthcare providers to facilitate smooth transitions between various levels of care
  • Schedule appointments, track patient progress, and follow up on care plans to enhance health outcomes
  • Maintain detailed documentation of patient interactions and services provided to ensure comprehensive healthcare support

Client Service Representative

Evolent Health
02.2024 - 10.2024
  • Company Overview: Contract
  • Managed sensitive client information with discretion, ensuring confidentiality and trust in all interactions
  • Processed and uploaded medical documents, facilitating efficient client service and document management
  • Provided prompt and accurate information for prior authorizations through effective communication on incoming calls, maintaining detailed records to enhance future client engagements
  • Contract

Customer Service and Claims Specialist

Elevance Health
08.2021 - 05.2022
  • Company Overview: Contract
  • Resolved complex issues related to claims, authorizations, and benefits, providing comprehensive support to members
  • Analyzed claims data to identify discrepancies and rectify errors, facilitating efficient payment processing
  • Ensured compliance with Medicaid and Medicare guidelines, acting as a liaison between providers and members to enhance communication and trust
  • Contract

Customer Service and Claims Specialist

Aetna Healthcare
10.2018 - 10.2020
  • Assisted members in comprehending insurance benefits, claims processes, and policy details, enhancing customer satisfaction and understanding
  • Reviewed and processed claims accurately, ensuring compliance with company policies and federal regulations
  • Investigated and resolved claim discrepancies by collaborating with providers and team members, consistently exceeding performance metrics in call handling time and resolution rates

Customer Service Representative

Molina Healthcare
10.2017 - 10.2018
  • Provided exceptional customer service by addressing inquiries and resolving issues, resulting in a customer satisfaction rating exceeding 95%
  • Managed sensitive patient information in accordance with HIPAA regulations and collaborated with internal departments to expedite claim resolutions and address member concerns

Education

Bowie High School
Arlington, Tx
2009

Skills

Expert in Software

Software

Microsoft

Excel

Outlook

Timeline

Care Coordination Specialist

Signify Health
11.2024 - Current

Client Service Representative

Evolent Health
02.2024 - 10.2024

Customer Service and Claims Specialist

Elevance Health
08.2021 - 05.2022

Customer Service and Claims Specialist

Aetna Healthcare
10.2018 - 10.2020

Customer Service Representative

Molina Healthcare
10.2017 - 10.2018

Bowie High School

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Regina Carter