Sarah Sichting
Winchester,IL
Summary
I am an organized and motivated professional with 5+years of experience in the insurance and medical industry. I have a deep knowledge of claims processing and customer service, and would be a reliable asset to any organization.
Overview
2025
2025
years of professional experience
Work History
Grievance & Appeals Analyst Temp
Media Riders
- Actively monitored progress on pending appeal cases ensuring timely completion of tasks associated with each claim dispute resolution.
- Reviewed documents for accuracy and completeness prior to processing appeals.
- Conducted research on evidence submitted in support of appeals.
- Performed quality assurance reviews of completed appeals cases to ensure accuracy and completeness.
- Maintained accurate records of all activities related to the appeals process.
- Analyzed and evaluated appeals to ensure compliance with applicable laws, regulations, policies and procedures.
- Input claim information and payments into company database.
Customer Care Advocate
Prudential
Remote, IL
10.2021 - 11.2024
- Listen to sales calls & receive sales call related complaints
- Work with multiple lines of Prudential business such as Life, Health, & Medicare plans
- Determine if the complaint is substantiated
- Investigate, analyze, and validate sales call complaint Medicare Advantage claims from start to finish.
- Resolved customer complaints in a timely manner while maintaining high levels of customer satisfaction.
- Identified trends in customer feedback and reported them to management for further investigation.
- Analyzed call logs to identify areas where improvement is needed.
- Managed escalated calls from customers who are dissatisfied with service received.
- Participated in team meetings to discuss new initiatives and ideas for enhancing the overall customer experience.
- Coordinated with other departments to ensure seamless resolution of customer requests.
- Maintained records of customer interactions, transactions, comments and complaints.
- Created detailed reports about customer service activities as requested by management.
- Maintained accurate records of customer interactions in CRM system for future reference.
- Promptly responded to customer inquiries and resolved complaints to promote loyalty.
Claims Technician
Blue Cross Blue Shield
08.2017 - 10.2020
- Perform data input, processing and retrieving claims
- Learned basic insurance policy information
- Exposed to different types of paperwork and filing systems for claims
- Typed investigation reports using data sheets
- Organized claims to process older claims prior to new claims
- Met with management to discuss weekly/monthly goals and strategies
- Processed daily charges for submission of claims
- Follow up on claims that were past due, paid incorrectly, or incorrect statements
- Balancing daily reports for Explanation of Benefits.
- Maintained accurate records of all claims activity in the database system.
- Assigned appropriate codes to claims based on diagnosis, procedure, and services provided.
- Conducted quality assurance reviews on approved and denied claims to ensure compliance with regulations and company policies.
- Reviewed and processed incoming claims for accuracy and completeness.
- Verified insurance coverage, eligibility, and benefit levels of claimants.
- Researched claim inquiries from providers and members in order to resolve discrepancies.
- Identified areas for improvement in existing processes and procedures.
- Assisted team members with troubleshooting technical difficulties related to software applications used in the processing of claims information.
- Responded promptly to customer inquiries regarding claim status or other issues related to their accounts.
- Performed data entry tasks related to processing of claims information into internal systems.
- Attended training sessions designed specifically for Claims Technicians in order to stay current with industry changes or updates.
- Supported efficient handling of complex claims and followed up on open, denied, or suspended claims to complete required line items.
- Processed claims for payment or forwarded to appropriate personnel for further investigation
- Examined claims, records and procedures to grant approval of coverage.
CNA - Certified Nursing Assistant
Liberty Village
08.2015 - 12.2015
- Obtain patient's vitals
- Transfer patients from wheelchair to bed or vice versa as required
- Assist patient with bathing and eating
- Dispense patient medication
- Apply bandages and supports as directed by nurse
- Document patient actions and events
- Transmit patient concerns to relevant personnel.
- Educated patients on self-care techniques that would help them maintain their independence.
- Provided assistance with activities of daily living, including bathing, dressing and grooming.
- Answered patient call lights promptly and responded to requests appropriately.
- Ensured compliance with HIPAA regulations regarding confidentiality of information.
- Assisted with range of motion exercises and other rehabilitative activities per physician orders.
- Demonstrated excellent customer service skills when interacting with patients, families and guests.
- Monitored food intake and output as directed by nursing staff.
- Monitored vital signs such as pulse rate, respiration rate, and blood pressure.
- Provided emotional support to family members during difficult times.
- Assisted in preparing meals according to prescribed diets while monitoring food consumption levels.
- Reported changes in patient conditions to registered nurse or physician.
- Recognized signs, symptoms of abuse, neglect and reported them per policy.
- Documented patient care services by charting in designated areas.
- Maintained a clean, safe environment for the patient by adhering to infection control policies and procedures.
- Observed patients for any physical or emotional changes, reported findings to medical staff immediately.
- Observed and reported unusual symptoms and changes to charge nurse.
- Used mobility devices to transport patients.
- Distributed drinking water and nourishment to residents.
Education
High school or equivalent -
Westfair Christian Academy
Medical Assistant -
Midwest Technical Institute
Skills
- Strong organizational and leadership skills
- Strong communication skills
- Database and records management
- Grievance & Appeals
- Filing and data entry
- Providing and maintaining exceptional member service
- Medical Records
- Medical Billing
- Medical Terminology
- ICD 10
- Medicare
- Insurance Verification
- Quality Assurance
- Medical documentation
- Problem-solving capabilities
- Organizational abilities
- Team Collaboration
- Task Prioritization
- Problem-Solving
- Self Motivation
- Data Entry
- CRM Software
Timeline
Customer Care Advocate
Prudential
10.2021 - 11.2024
Claims Technician
Blue Cross Blue Shield
08.2017 - 10.2020
CNA - Certified Nursing Assistant
Liberty Village
08.2015 - 12.2015
High school or equivalent -
Westfair Christian Academy
Medical Assistant -
Midwest Technical Institute
Grievance & Appeals Analyst Temp
Media Riders