Staci-Ann Cox
Columbus,GA
Summary
Efficient professional in insurance claims and policy processing, known for high productivity and the ability to complete tasks with precision. Specialized in analyzing claim details, navigating policy databases, and managing customer communications. Excel in problem-solving, adaptability, and teamwork, leveraging these soft skills to navigate complex situations and achieve positive outcomes.
Overview
4
4
years of professional experience
Work History
Remote Customer Service Representative
Elevance Health
Columbus , Georgia
05.2022 - 12.2022
- Prepared and evaluated CRM reports to identify problems and areas for improvement.
- Processed patient responsibility estimate determined by insurance at pre-registration.
- Coordinated with internal teams to ensure timely and successful delivery of solutions according to client needs.
- Generated monthly performance metrics reports based on customer feedback survey results.
- Reviewed eligibility responses to assess patient benefit level and prepare estimates.
- Managed multiple projects simultaneously while meeting deadlines set by management team members.
- Monitored reinsurance recoveries and processed claims efficiently.
- Maintained a comprehensive understanding of insurance principles and industry standards in order to provide accurate advice when needed.
- Conducted audits of health insurance claims processing systems for accuracy and efficiency.
- Resolved customer queries related to health insurance claims, payments, reimbursements.
- Documented all interactions related to health insurance claims processing in a secure system.
- Monitored health insurance claims data for accuracy and completeness.
- Reviewed patient records to ensure accurate and timely billing of health insurance claims.
Remote Customer Service Representative
UnitedHealthcare
Columbus, Georgia
11.2020 - 05.2021
- Analyzed data sets from various sources such as patient records or health insurance claims to inform decision-making.
- Processed payments for health insurance claims according to established guidelines.
- Researched various sources such as payer websites and provider manuals for clarification on rules and regulations pertaining to health insurance claims processing.
- Provided customer service to internal and external customers related to health insurance claims, billing issues, and policy questions.
- Maintained a comprehensive knowledge of relevant laws, regulations, and industry standards regarding health insurance claims processing.
- Worked closely with team members and other departments within the organization on matters relating to health insurance claims processing.
- Processed applications for health insurance policies and ensured accuracy of information provided.
- Monitored clients' insurance coverages to ensure changing needs were met.
Sales Associate
Sally Beauty
Columbus, GA
05.2019 - 01.2021
- Assisted in visual merchandising, creating appealing displays that capture customer interest.
- Computed purchases and received and processed cash or credit payment.
- Sold various products by explaining unique features and educating customers on proper application or usage.
- Described merchandise and explained use, operation and care.
- Handled returns and exchanges according to company policies.
- Provided accurate information about products, prices and services.
- Developed promotional strategies to increase sales volume.
- Watched for and recognized security risks and thefts to prevent or handle situations.
- Received and displayed product shipments on store retail shelves upon delivery.
Education
Some College (No Degree) - Nursing
Bethune-Cookman University
Daytona Beach, FLSkills
- Complaint resolution
- Scheduling
- Account updating
- Medical terminology
- CRM software
- Computer proficiency
- Strong teamwork
- Organization
- Client education
- Insurance terminology
- Account management
- Claims documentation
- Personal data evaluation
- Attention to detail
- Critical thinking
- Policy requirements and eligibility
- Data entry
- Patient contact
- Reporting
- Call center operations
- Time management
Timeline
Remote Customer Service Representative
Elevance Health
05.2022 - 12.2022
Remote Customer Service Representative
UnitedHealthcare
11.2020 - 05.2021
Sales Associate
Sally Beauty
05.2019 - 01.2021
Some College (No Degree) - Nursing
Bethune-Cookman University
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