SHAQUITA BENSON
Cypress,TX
Summary
Claims Adjuster
Overview
5
5
years of professional experience
1
1
Certification
Work History
Complex Customer Service Rep
UnitedHealth Group
Remote
02.2023 - Current
- Demonstrated excellent communication skills, both verbal and written, in order to effectively interact with customers.
- Assisted with reviewing medical benefits/ plans
- Reviewed complex medical claims and assisted with any discrepancies.
- Assisted customers with prior authorization request
- Assisted with ordering member ID cards for members
- Assisted members with connecting with Registered Nurses for clinical needs.
- Assisted with various projects to help ensure success in department.
- Developed positive relationships with customers through friendly interactions.
Claims Adjuster
Crawford & Company - Citizens Property Insurance
Atlanta, Georgia
02.2022 - Current
- Utilized Xactianalysis to examine and review policy information
- Identified and assessed property damage using GIC, photos, etc
- Informed clients of the policy limits, claim process, and necessary repairs
- Assisted in preventing loss due to insurance fraud and recommended claims for further review
- Utilized Xactimate to estimate damage, creating sketches, line items, etc
- Provided excellent customer service to policy holders and involved parties throughout the process.
Healthcare Verification Specialist
IBM Corporation
Atlanta, Georgia
06.2022 - 12.2022
- Examined insurance plans to determine coverage for prescriptions
- Verified pharmacy/ medical benefits coverage w/ PBM via telephone
- Contacted policy holders to explain prescription coverage, informed patients of copay assistant programs, pre-authorization process, and prescription denials
- Communicated with Health insurance plan to provide updates on prescription changes, claim rejections, and override assistance
- Updated patient demographic information.
Revenue Cycle Representative
Grady Memorial Hospital Emergency Room
Atlanta, GA
04.2019 - 09.2021
- Used EHR (Epic) to collect and process co-payments and out-of-pocket expenses
- Collected copayments and kept track of my finances on a daily basis
- Obtained the patient's insurance information and determined whether or not the patient was eligible for benefits for the services rendered
- Used my knowledge of electronic medical record systems and medical terminology to perform various data entry tasks
- Assessed patients' financial needs and referred them to the appropriate county, state, or federal agencies for assistance
- Assisted with patient scheduling, appt
- Confirmations, cancellations, and voicemails via telephone (100+ calls daily).
Education
Associate of Applied Science - Nursing
Kishwaukee College
Skills
- EMR Proficiency
- Caseload Management
- Medical terminology knowledge
- Insurance policy review
- Maintaining records
- Data entry
Certification
- Property & Casualty License
- Real Estate Salesperson
Timeline
Complex Customer Service Rep
UnitedHealth Group
02.2023 - Current
Healthcare Verification Specialist
IBM Corporation
06.2022 - 12.2022
Claims Adjuster
Crawford & Company - Citizens Property Insurance
02.2022 - Current
Revenue Cycle Representative
Grady Memorial Hospital Emergency Room
04.2019 - 09.2021
Associate of Applied Science - Nursing
Kishwaukee College