Rosonja Atelonie
Tampa
Summary
Detail-oriented Healthcare Claims Analyst with 3+ years of experience reviewing, processing, and resolving claims in high-volume environments. Skilled in analyzing discrepancies, verifying benefits, ensuring compliance with HIPAA, and maintaining accurate documentation. Strong background in customer support, fraud review, and cross-functional collaboration.
Overview
6
6
years of professional experience
2018
2018
years of post-secondary education
Work History
Claims Processor
United Healthcare
10.2023 - Current
- Review and analyze claims for accuracy, eligibility, and billing discrepancies
- Investigate and resolve claim issues including premium errors and coverage questions
- Verify benefits and determine coverage based on plan guidelines
- Maintain detailed documentation to support audit readiness
- Collaborate with internal teams to resolve payment discrepancies
- Support member and provider inquiries related to claims and benefits
- Ensure compliance with HIPAA and data privacy standards
Scheduling & Customer Support Associate
Restoration Hardware
02.2021 - 09.2023
- Managed high-volume order and account transactions, ensuring accuracy of customer records and system updates
- Provided proactive and reactive communication via phone and email to resolve inquiries and discrepancies
- Analyzed account issues to identify delays, inconsistencies, and potential roadblocks
- Collaborated with store, supply chain, and delivery teams to ensure timely resolution
- Maintained detailed documentation of interactions and resolutions within internal systems
- Investigated and resolved billing issues, refunds, cancellations, and account discrepancies
- Communicated updates and case details to internal teams for continuity
- Verified customer information across systems to ensure data accuracy
- Managed multiple priorities while meeting deadlines in a fast-paced environment
- Delivered strong customer service through effective problem-solving and communication
Customer Service & Fraud Representative
Bank of America
04.2020 - 02.2021
- Investigated fraudulent and unauthorized transactions
- Processed chargebacks and reconciled financial accounts
- Reviewed account activity to identify discrepancies
- Maintained confidentiality of sensitive financial data
Education
Diploma -
Tampa Bay Technical High School
Tampa, FLSkills
- Claims Analysis & Resolution
- Billing Discrepancies
- Fraud Detection
- Benefits Verification
- Documentation
- Customer Support
- Data Accuracy
- Financial Reconciliation
- HIPAA Compliance
- Microsoft Office
- Clear verbal and written communication
Open To Remote Roles
True
Timeline
Claims Processor
United Healthcare
10.2023 - Current
Scheduling & Customer Support Associate
Restoration Hardware
02.2021 - 09.2023
Customer Service & Fraud Representative
Bank of America
04.2020 - 02.2021
Diploma -
Tampa Bay Technical High School