Shadiamond Wilson

Work History

Tegria

Birmingham, AL

06.2020 - Current

Compiled and tracked outstanding balances owed to medical facilities.
Processed online and paper appeal submissions and refund requests.
Corrected, completed and processed claims for multiple payer codes.
Responded to customer concerns and questions on daily basis.
Reconciled accounts receivable to general ledger.
Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
Communicated with insurance companies to research and resolved coding discrepancies.
Assisted in preparation of medical reports for external parties.
Tracked and monitored requests for medical records release.
Communicated effectively with staff, patients, and insurance companies by email and telephone.
Collected payments and applied to patient accounts.
Posted payments and collections on regular basis.

Blue Cross Blue Shields

Birmingham, AL

04.2018 - 03.2020

Reviewed provider coding information to report services and verify correctness.
Responded to correspondence from insurance companies.
Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
Used administrative guidelines as resource or to answer questions when processing medical claims.
Managed large volume of medical claims on daily basis.
Identified and resolved discrepancies between patient information and claims data.
Followed up on denied claims to verify timely patient payment and resolution.
Generated, posted and attached information to claim files.
Coordinated with contracting department to resolve payer issues.
Notified insurance agents and accounting departments of policy cancellations and changes.

T-Mobile

Birmingham, AL

12.2016 - 02.2018

Worked within task management system to receive, manage and close support requests.
Managed fast-paced call center work to assist high volume of daily customers using multiple internal databases and systems.
Crafted intelligent, professional responses to emailed and web chat customer questions.
Tracked changing software and technologies with potential to impact customer requirements.
Identified trends in client requests and helped management get ahead of ongoing problems.
Partnered with sales, operations and field service teams to coordinate solutions.
Assisted sales team by creating and maintaining supporting data files.
Supported customers throughout incident response, management and resolution to deliver expert assistance for technical needs.
Managed timely and effective replacement of damaged or missing products.

Wells Fargo

Birmingham, AL

04.2014 - 12.2016

Leveraged deep knowledge and understanding of banking industry to handle customer inquiries with increasing complexity.
Reviewed and verified vendor completeness and compliance to rectify billing disputes and fraud cases.
Built strong relationships with customers to increase retention and loyalty.
Evaluated customer creditworthiness and financial statements to determine credit limits.
Implemented strategies to reduce risk of credit card fraud and identity theft.
Worked in tandem with sales team and customers to negotiate payments and verify account reconciliations.
Analyzed creditworthiness of loan applicants and determined credit risk of loan requests.
Negotiated payment plans and loan terms with delinquent customers.