Rhonda Boyd
Portland,OR
Summary
With over 15 years in medical insurance, expertise lies in customer service and claims processing. Proven ability to resolve complex issues, train team members, and maintain a customer-focused environment through effective communication.
Overview
31
31
years of professional experience
Work History
SR Customer Service Agent
PacifiCorp
Portland, OR
2023.08 - 2026.06
- Delivered customer service to existing and future customers through billing, credit and collections, service requests, energy efficiency, and customer account management, fostering a customer-focused environment through continuous learning and skill development.
- Provided expert support to customers regarding billing and account inquiries.
- Resolved complex customer issues through effective communication and problem-solving skills.
- Trained new team members on company policies and customer service best practices.
Customer Service Representative I
CareOregon Inc
Portland, OR
2021.08 - 2023.01
- Researched, verified, and resolved inquiries on Oregon Health Plan or Medicare eligibility, ensuring accurate information was provided with guidance from supervisors. Assisted members with Primary Care Provider (PCP) assignments, facilitating access to necessary healthcare services. Work collaboratively with providers, DMAP, or members to ensure effective customer service and the resolution of health plan problems. Documented all activities using online Call Tracking system, maintaining comprehensive records of communications with members, providers, and other customers. Coordinated mailing of member materials. Provide cross-training on specific job responsibilities.
- Responded to customer inquiries and provided effective resolutions.
- Provided support for billing questions and insurance coverage clarifications.
- Resolved customer complaints by demonstrating empathy and professionalism.
Pre Services Representative
Adventist Health Medical Center
Portland, OR
2018.04 - 2021.05
- Verified insurance and obtained authorizations for Rev Cycle services, negotiated and processed patient payments. Executed routine assignments within defined parameters and established guidelines. Updated patient accounts to ensure accurate medical and financial eligibility. Compiled and maintained reports on case qualifications to support compliance and operational efficiency. Obtained all necessary billing, insurance, and other demographic information from patients or representatives.
- Scheduled patient appointments and addressed inquiries to enhance service delivery.
- Offered emotional support to patients and families during their healthcare visits.
- Organized and updated patient records within electronic health record systems to ensure accuracy.
Defined Contributions Associate II
Standard Insurance/Volt Agency
Portland, OR
2017.03 - 2018.03
- Quality checked plan and participant contributions, enrollments, investment directives, participant requested distributions, workflow tickets, and loans to ensure compliance and accuracy. Process and quality check excess contributions and required minimum distributions for testing failures in coordination with the compliance team. Ensured quality assurance across group processes to maintain operational integrity and reliability. Train and mentor Defined Contribution Assistant I’s and/or interns. Cross trained for other functional team responsibilities to provide assistance during peak work periods. Served as resource for Account Managers and Contact Center, facilitating effective processing and support.
- Executed daily operational tasks with precision in a fast-paced environment.
- Proposed creative strategies and solutions to improve team effectiveness and results.
- Worked successfully with a diverse group of coworkers to accomplish goals and address issues related to our products and services.
Customer Service Representative SAFE 4
Wells Fargo Bank
Beaverton, OR
2014.10 - 2016.12
- Identified solutions for home equity line or loan customers nearing end of draw period and communicated options effectively. Conducted account reviews of home equity lines of credit to align credit limits with borrowers' financial conditions. Educated customers on Wells Fargo home equity programs, rates, and loan procedures to enhance understanding and streamline processes. Answered inquiries and resolved problems regarding products and services. Evaluated transactions for accuracy and completeness, ensuring compliance and reducing potential errors.
- Provided support to customers with account inquiries and transaction processes, ensuring clear communication and satisfaction.
- Addressed customer complaints in a timely and professional manner, maintaining a high standard of service.
- Informed clients about various banking products and services available, helping them make informed decisions.
Patient Access Specialist (Temp)
Kd Temporary Staffing/Kaiser Permanente
Portland, OR
2014.01 - 2014.07
- Managed patient registration and scheduling processes efficiently.
- Coordinated insurance verification and eligibility checks for patients.
- Assisted patients with inquiries and resolved access-related issues.
- Handled telephone reception and appointment scheduling for patients according to regional policies and procedures.
Medical Records Specialist I
Regence BlueCross BlueShield
Portland, OR
2007.04 - 2013.08
- Protect the security of medical records to ensure that confidentiality is maintained and HIPAA compliant. Reviewed medical records for completeness, accuracy, and regulatory compliance, ensuring adherence to standards. Requested patient medical records from physicians and technicians. Composed and sent letters to providers regarding records requests and followed up to ensure timely receipt of records. Assigned patients to appropriate diagnosis-related groups (DRGs) using specialized software., using appropriate computer software. Clarified and resolved coding or diagnosis discrepancies by consulting with doctors through written and verbal communication. Entered data to request medical records.
- Managed patient medical records using electronic health record systems.
- Ensured compliance with healthcare regulations and privacy standards.
- Organized and maintained physical and digital medical files efficiently.
Customer Service Rep II
Regence BlueCross BlueShield
Portland, OR
2007.04 - 2013.08
- Conferred with providers by telephone or correspondence to provide information about claim status and entered claims into a database, ensuring accurate documentation. Checked and confirmed appropriate changes made to resolve customers' problems, enhancing customer satisfaction. Maintained records of customer interactions and transactions, detailing inquiries, complaints, and actions taken. Resolved customers' service or billing complaints through adjustment of claims, leading to timely resolution of issues. Adjusted insurance claims or related documents and reviewed them for completeness. Organized or worked with detailed office records, using computers to enter, access, search, or retrieve data.
- Addressed customer concerns through effective communication and resolution strategies. through effective communication and problem-solving techniques.
- Supported members by answering questions about health benefits and claims processes. with inquiries regarding health benefits and claims processes.
- Informed clients about various insurance products and available coverage options. on various insurance products and coverage options available.
Associate Medical Underwriter
Standard Insurance
Portland, OR
1995.07 - 2005.09
- Evaluated medical histories for risk assessment and underwriting decisions.
- Analyzed insurance applications for completeness and accuracy.
- Collaborated with healthcare providers to gather necessary documentation.
- Opened and date stamped incoming applications and reviewed them for processing. Assessed insurance claims to verify coverage amounts for individual risks or groups of related risks. Modify, update, and process existing policies and claims to reflect any change in beneficiary, amount of coverage, or type of insurance. Process and record new insurance policies and claims. Reviewed insurance policy to determine coverage. Fostered strong relationships with customers, brokers, sales, and internal and external partners to enhance communication and service.
Education
Medical/Business Courses -
Portland Community College
Portland, ORSkills
- Customer support
- Billing and collections expertise
- Claims processing
- Claims eligibility systems knowledge
- Data entry proficiency
- Familiarity with billing software
- Microsoft Office suite
- Medical terminology proficiency
- Organized and analytical
- Team collaboration
- Dependability
- Self-motivation
- Communication skills
Timeline
SR Customer Service Agent
PacifiCorp
2023.08 - 2026.06
Customer Service Representative I
CareOregon Inc
2021.08 - 2023.01
Pre Services Representative
Adventist Health Medical Center
2018.04 - 2021.05
Defined Contributions Associate II
Standard Insurance/Volt Agency
2017.03 - 2018.03
Customer Service Representative SAFE 4
Wells Fargo Bank
2014.10 - 2016.12
Patient Access Specialist (Temp)
Kd Temporary Staffing/Kaiser Permanente
2014.01 - 2014.07
Medical Records Specialist I
Regence BlueCross BlueShield
2007.04 - 2013.08
Customer Service Rep II
Regence BlueCross BlueShield
2007.04 - 2013.08
Associate Medical Underwriter
Standard Insurance
1995.07 - 2005.09
Medical/Business Courses -
Portland Community College