Selena Reeves
Tampa,FL
Summary
Accomplished professional with expertise in adapting to evolving customer and organizational demands. Proficient in conflict resolution and maintaining composure in high-pressure situations. Recognized for commitment to teamwork and achieving shared goals.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Provider Reconsider Analyst
Elevance Health
12.2018 - Current
- Clarified benefits for plan participants, making complex information easy to understand.
- Delivered top-tier internal customer service through expert knowledge of package offerings.
- Coordinated continuous enrollment processes along with annual enrollment periods seamlessly.
- Verified accuracy and completeness of benefits paperwork during reviews.
- Administered billing operations using ICD 9 and 10 codes for accurate claims processing.
- Addressed appeals and grievances, ensuring efficient resolution for participants.
- Answering Inbound calls assisting employees with their annual benefit enrollment and life event changes
Front Desk Office Assistant
Progressive Physical Therapy And Rehabilitation
09.2017 - 11.2018
- Organized paperwork such as charts and reports for office and patient needs.
- Checked patient data including insurance, demographic and health history to ensure all information was current.
- Promptly answered multi-line phone system and greeted callers enthusiastically.
- Scheduled, rescheduled and handled cancelled appointments for patients.
- Obtained payments from patients and scanned identification and insurance cards.
- Billing claims and assisted looking up claims for providers
Client Service Coordinator
Health Integrated Inc.
12.2015 - 08.2017
- Answered phone with friendly greeting to create positive inbound calling experience for customers.
- Assist clients and members with benefit and coverage information.
- Followed-through on all critical inter-departmental escalations to increase customer retention rates.
- Processed faxes and inbound call request for pre-authorization for Family Health Plan Network insurance.
Customer Solutions Expert
CareCentrix Inc.
01.2010 - 11.2015
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
- Received and responded to incoming calls or faxes from providers, referral Sources, and potential patients, Accurately enter information to begin the referrals process into the CareCentrix portal
- Increased efficiency and team productivity by promoting adherence to operational best practices and company policies.
- Conferred with customers about concerns with products or services to resolve problems and drive sales.
Workers' Compensation Claims Adjuster
NSI
02.2002 - 01.2010
- Maintained contact with claimants and attorneys to determine treatment status.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.
- Collected Type information from customers to complete claims and legal files.
- Examined claims forms and other records to determine insurance coverage.
- Documented information gathered in field and uploaded data to company database for efficient processing using Software.
- Verified accuracy of Type records to maintain accuracy of records database.
- Followed up on potentially fraudulent claims initiated by claims representatives.
Education
High School Diploma - undefined
Hillsborough High School
Tampa, FLHome Health Aide - undefined
Leary Technical College
Tampa, FLSkills
- Customer service expertise
- Administrative assistance
- Benefits coordination
- Personable demeanor and interaction
- Team-oriented mindset
- Proficient in Microsoft Office applications
- Telephone and email professionalism
- Multi-tasking capabilities
- Active listening techniques
- Data entry proficiency
- Conflict resolution skills
- Communication proficiency
- Time management skills
- Team enhancement
Accomplishments
- Collaborated with team of Number in the development of Project name.
- Used Microsoft Excel to develop inventory tracking spreadsheets.
- Documented and resolved Issue which led to Results.
- Achieved Result by completing Task with accuracy and efficiency.
- Achieved Result through effectively helping with Task.
Certification
- Area of certification Training - Timeframe
Work Type
Full TimeWork Location
RemoteHybridTimeline
Provider Reconsider Analyst
Elevance Health
12.2018 - Current
Front Desk Office Assistant
Progressive Physical Therapy And Rehabilitation
09.2017 - 11.2018
Client Service Coordinator
Health Integrated Inc.
12.2015 - 08.2017
Customer Solutions Expert
CareCentrix Inc.
01.2010 - 11.2015
Workers' Compensation Claims Adjuster
NSI
02.2002 - 01.2010
High School Diploma - undefined
Hillsborough High School
Home Health Aide - undefined
Leary Technical College
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