Summary
Overview
Work History
Education
Skills
Timeline
Generic

SALEANA BROWN

Kansas City,United States

Summary

Experienced Case Processor with 8+ years of expertise in fraud investigation, claim processing, and customer service. Recognized for strong communication skills, keen attention to detail, and effective organizational capabilities. Continually enhances case resolution efficiency and customer satisfaction. Proficient in managing communication platforms and collaborating with diverse teams to enhance security protocols.

Overview

9
9
years of professional experience

Work History

Patient Care Coordinator

Optum
11.2024 - Current
  • Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times.
  • Provided exceptional customer service by addressing concerns, answering questions, and ensuring patient satisfaction with their care experience at the clinic.
  • Enhanced patient satisfaction by efficiently scheduling appointments and managing patient flow.
  • Streamlined communication between patients and healthcare providers, ensuring timely responses to inquiries and concerns.
  • Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.

CASE PROCESSOR

U.S. Bank
01.2021 - 11.2024
  • Managed diverse communication channels with customers and merchants through telephone, mail, and fax to conduct our reasonable investigation to accurately handle each case.
  • Worked with various forms of technology, including transactions processing systems, risk management platforms, case management applications, and researching and analytical tools.
  • Followed established guidelines and procedures. Conducted thorough investigations of fraudulent transactions, applying Visa regulations to resolve new and existing claims.
  • Partnered with cross-functional teams to develop and implement enhanced fraud detection strategies, strengthening overall security measures.
  • Managed multiple claims on an ongoing basis while maintaining appropriate documentation and staying within department and regulations Z timeframes.

MEMBER SUPPORT REPRESENTATIVE

Sun Life Financial
11.2018 - 12.2020
  • Managed multiple tasks and projects, ensuring timely completion and high attention to detail.
  • Resolved claims and issues by following established policies, enhancing customer satisfaction.
  • Collaborated with internal and external customers to gather and relay critical information.
  • Identified and obtained missing information, ensuring accurate system inputs.
  • Built strong partnerships and operated as a team player to achieve excellence.

CUSTOMER SERVICE AGENT

DST Systems Inc.
09.2016 - 10.2018
  • Collaborated with claims department and anti-fraud organization to resolve claims efficiently.
  • Collected premiums on direct collection files, ensuring timely and accurate processing.
  • Processed high volumes of credit and debit transactions in batches, maintaining accuracy.
  • Identified and managed various risk types and information breaches.
  • Supported PC-based and mainframe systems and software.

Education

HIGH SCHOOL DIPLOMA - undefined

Center High School
Kansas City, Mo

Skills

  • Fraud Investigation (Expert)
  • Communication (Expert)
  • Attention to Detail (Expert)
  • Medical Terminology (Experienced)
  • Multi-line Phone (Expert)
  • POS System (Expert)
  • MS Windows (Expert)
  • Organization (Experienced)
  • Claims review (Expert)
  • Accuracy and precision (Expert)
  • Claims (Expert)
  • Regulatory compliance (Expert)

Timeline

Patient Care Coordinator

Optum
11.2024 - Current

CASE PROCESSOR

U.S. Bank
01.2021 - 11.2024

MEMBER SUPPORT REPRESENTATIVE

Sun Life Financial
11.2018 - 12.2020

CUSTOMER SERVICE AGENT

DST Systems Inc.
09.2016 - 10.2018

HIGH SCHOOL DIPLOMA - undefined

Center High School

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