Experienced with handling customer interactions and resolving issues promptly. Utilizes communication and empathy to build strong customer relationships. Track record of maintaining high customer satisfaction and fostering loyalty.
Overview
8
8
years of professional experience
Work History
Medical Claims Examiner
National Employee Benefits Administration
10.2021 - Current
Assisted in the training and onboarding of new team members, sharing knowledge and best practices to ensure their success.
Reduced errors in claim submissions by meticulously reviewing patient information and verifying insurance eligibility.
Increased productivity by implementing efficient strategies for handling high volumes of medical claims daily.
Managed large volume of medical claims on daily basis.
Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
Paid or denied medical claims based upon established claims processing criteria.
Remote Customer Service Representative, Chat Agent
Solstice Benefits
10.2019 - 09.2021
Answer calls and respond to emails
De-escalate situations involving dissatisfied customers, offering patient assistance and support
Review customer or client accounts, providing updates and information about billing, claims, and benefits
Responding to customer inquiries quickly, directly, and concisely by chat and email
Customer Service Representative
Cross Country Home Services
02.2017 - 07.2019
Inbound and outbound calls in a timely manner
Follow communication “scripts” when handling different topics
Document all call information according to standard operating procedures
Follow up customer calls where necessary
Education
High School Diploma -
Stranahan High School
Fort Lauderdale, FL
06.2010
Skills
40 WPM Typist
Experience with Microsoft Office
Excellent oral and written communication skills
Customer service
Multi-Task Management
Claims processing proficiency
HIPAA compliance
Insurance claims processing
Timeline
Medical Claims Examiner
National Employee Benefits Administration
10.2021 - Current
Remote Customer Service Representative, Chat Agent
Solstice Benefits
10.2019 - 09.2021
Customer Service Representative
Cross Country Home Services
02.2017 - 07.2019
High School Diploma -
Stranahan High School
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