Sandra Womack-Dunn
Lancaster,TX
Summary
Dedicated professional with 11 years of experience in customer service and data management, adept at resolving complaints, and maintaining high satisfaction levels. Skilled in meeting targets, managing phone communications, and ensuring accurate data entry. Seeking to leverage expertise in a Customer Service/Data Entry role. I have a Claim adjuster license with several certificates and interested in focusing on a new avenue of life.
Overview
12
12
years of professional experience
Work History
Owner Operator/Dispatcher
Diri Transportation/Notary
01.2020 - Current
- Identifies customer needs and works to meet those needs using appropriate customer service skills
- Being able to listen to the customers to response all issues
- Oversee route scheduling to ensure safe and efficient freight delivery
- Maintain meticulous records and submit driver and company documentation punctually
- Accurately and efficiently posting of sales orders
- Update and maintain all report from corrections of 10 key Data entry actions
- Strong attention to detail to uphold accuracy
- Resolve customer and logistical issues, demonstrating strong problem-solving and customer service abilities
- Manage regulatory compliance, including permit acquisition and adherence to weight restrictions.
Senior Claims Analyst
United HealthCare/Optum 360
05.2019 - 11.2022
- Communicating with insurance companies, patients and Medicare to resolve issue so payment will be made.
- Identifies customer needs and works to meet those needs using appropriate customer service skills
- Applies a basic understanding of systems and technology used within the company
- Managed the submission of critical physician licensing and DEA documentation, ensuring ongoing compliance and timely renewals
- Analyzed and resolved pending claims, focusing on efficient processing according to prioritizing criteria
- 10 Key data to update of reports and spreadsheets
- Accurately posting information on spreadsheets
- Coordinated with Medicare billing staff, assigning tasks to facilitate prompt claim reimbursements
- Conducted thorough quality assurance reviews, maintaining high standards for claims accuracy and adherence to contractual obligations.
Medicare Biller
Christus Health
03.2016 - 05.2019
- Served as a liaison to reconcile claim payment discrepancies, facilitating effective communication between payers and members
- Analyzed trends, tracked reimbursements, and reviewed contracts to confirm payments aligned with payer agreements
- Managed the verification of insurance coverage, authorization processes, and documentation for claim adjudication accuracy.
Patient Care Lead/Medicare Biller
SSM HEALTHCARE
10.2012 - 03.2016
- Coordinated pre-authorization processes for patient procedures, ensuring all necessary approvals were in place prior to operations
- Liaised with physicians' offices to secure authorization numbers and meticulously updated the hospital system with approval dates
- Analyzed and addressed daily reports of Medicare claim denials, identifying root causes and executing appropriate responses, including corrective claims or appeals
- Managed coordination of benefits issues, confirming primary payer details and rectifying discrepancies to expedite accurate Medicare reimbursements.
Education
License - Automotive
ALL LINES CLAIM ADJUSTER
Dallas, TX02.2024
Skills
- Customer Service
- Relationship Building
- Problem Solving
- Communication Skills
- Claim Adjuster License # 3139839
- Certificates for Auto adjusting Training classes
Timeline
Owner Operator/Dispatcher
Diri Transportation/Notary
01.2020 - Current
Senior Claims Analyst
United HealthCare/Optum 360
05.2019 - 11.2022
Medicare Biller
Christus Health
03.2016 - 05.2019
Patient Care Lead/Medicare Biller
SSM HEALTHCARE
10.2012 - 03.2016
License - Automotive
ALL LINES CLAIM ADJUSTER
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