Secquoyah Taylor
Milwaukee,WI
Summary
Results-oriented Claims Processing Associate with a track record of successfully managing and resolving insurance claims. Skilled in investigating claim holds, identifying underlying issues, and taking necessary actions to resolve them. Proven ability to maintain a high level of accuracy while working within tight deadlines. Strong time management and effective communication skills. Proficient in claims processing and medical billing.
Overview
8
8
years of professional experience
Work History
Customer Technical Support Analyst
Generac Power Systems
05.2024 - Current
- Streamlined support processes by developing comprehensive troubleshooting guides and resources.
- Delivered exceptional customer service through clear communication, empathy, and active listening skills.
- Boosted team morale by actively participating in group discussions, contributing ideas, and supporting colleagues'' professional growth.
- Assisted in onboarding new hires, providing training materials and mentorship on company policies and procedures.
- Expedited resolution times by quickly diagnosing root causes of problems and proposing appropriate fixes.
- Participated in regular team meetings to review performance metrics, discuss improvement strategies, and set goals for continued success.
- Developed strong relationships with clients by consistently exceeding expectations in problem-solving capabilities.
- Improved customer satisfaction by providing timely and effective technical support to a diverse client base.
- Used ticketing systems to manage and process support actions and requests.
Claims Processing Associate
Skygen USA
01.2021 - 01.2023
- Managed and resolved pending, denied, or incorrectly processed insurance claims
- Investigated claim holds, identified underlying issues, and took necessary actions to resolve them
- Reviewed denials, determined causes, and followed up with insurance carriers to correct claim statuses
- Provided additional documentation as needed to facilitate accurate claim processing or appeals
- Handled all correspondence, including emails, mail, and processing refunds
- Maintained a high level of accuracy while working within tight deadlines
- Assisted with additional duties as required by management
- Maintained up-to-date knowledge of changing regulations pertaining to processing activities
Customer Service Team Lead
Skygen USA
03.2019 - 01.2021
- Held regular team meetings to discuss progress towards goals and address any challenges or concerns
- Provided exceptional customer service and support to customers, resolving escalated issues quickly and efficiently
- Developed reports on team performance metrics for senior management review
- Established and maintained key performance metrics and quality assurance programs to increase customer satisfaction
- Followed procedures and scripts using fundamental knowledge to navigate information on CRM systems
- Provided customer service by greeting and assisting customers and responding to customer inquiries and complaints
- Authorized payments and merchandise returns
- Conducted regular team meetings to discuss progress, identify challenges, and share best practices
- Identified areas of improvement and created solutions to maximize operational efficiency
Reimbursement Specialist
Skygen USA
07.2017 - 01.2019
- Processed payments from insurance companies according to contractual agreements
- Acted as a liaison between providers and payers when disputes arose regarding claim payments or denials
- Adhered to HIPAA regulations while handling confidential patient information related to reimbursement claims
- Successfully managed complex billing and reimbursement issues for a high-volume organization
- Collaborated with other departments within the organization to ensure accurate reimbursement of services provided
- Resolved discrepancies with payor contracts, including coding, pricing and coverage determination
- Maintained current knowledge of all applicable laws governing healthcare reimbursement systems
- Provided timely responses to inquiries from patients, insurers, government agencies or other organizations regarding claims processing
- Investigated denied claims and submitted appeals as necessary for resolution of payment disputes
Education
Associates Degree -
Bryant & Stratton College
Wauwatosa, WISkills
- Time Management
- Customer Service
- Workflow Management
- Documentation & Reporting
- Teamwork
- Microsoft Suite Proficient
- Transaction Processing
- Medical Billing
- Effective Communication
- Written & Verbal Skills
- Data Review & Verification
- Computer Literacy
- Account Management
- Inbound & Outbound Call Handling
- Patient Support
- Problem-Solving & Analytical Thinking
- Typing Speed [60 WPM]
- Multitasking & Prioritization
Timeline
Customer Technical Support Analyst
Generac Power Systems
05.2024 - Current
Claims Processing Associate
Skygen USA
01.2021 - 01.2023
Customer Service Team Lead
Skygen USA
03.2019 - 01.2021
Reimbursement Specialist
Skygen USA
07.2017 - 01.2019
Associates Degree -
Bryant & Stratton College
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