Tamika Wilson
Hoover,AL
Summary
Highly motivated candidate adept at reviewing and verifying invoices for accuracy and completeness. Works collaboratively with other departments to resolve billing discrepancies and successfully manage accounts. Demonstrated success in developing and implementing billing procedures to facilitate prompt and accurate payments. Results-driven Online Chat Specialist promoting ways to improve customer engagement. A relationship-builder and multitasking professional Looking for the next amazing opportunity utilizing great skills in customer service in busy environment. Skilled professional with an extensive background in customer service. Calm and poised in the most pressure-driven situations. Pursuing an Online Chat Specialist position where excellent response and writing skills will help improve a company's success.
Overview
19
19
years of professional experience
Work History
Chat Support Representative
Fetch Rewards
01.2022 - 05.2023
- Monitored customer conversations and provided timely, knowledgeable assistance.
- Responded to customer inquiries and provided accurate information about products and services via live chat.
- Documented all customer information accurately in computer system, providing dated notes for future reference.
- Resolved customer complaints by identifying problems, suggesting solutions and implementing corrective action.
- Asked open-ended questions to determine which products or services would be best fit for customer's needs.
- Researched customer inquiries to provide accurate and up-to-date information.
- Handled inbound customer chat conversations from various websites.
- Trained new team members on live chat procedures and customer service protocols.
- Assisted department with email-based and phone support when call center was busy or short-staffed.
- Remedied issues quickly and within parameters of company-mandated policies and procedures.
- Assisted team leader with coaching and mentoring of new employees.
- Maintained up-to-date knowledge of product and service changes.
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
- Followed up with customers about resolved issues to maintain high standards of customer service.
- Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates.
Medical Billing Representative
Evolent Health
05.2019 - 01.2022
- Gave accurate and appropriate information to answer questions, troubleshoot issues and resolve complaints
- Recorded details of inquiries or complaints to maintain up-to-date records of customer interactions and transactions
- Made appropriate account corrections to resolve customer problems.
- Assisted customers in navigating through various web pages on company's website during their purchase process
- Utilized department and company ticketing systems to manage and resolve client needs.
- Handled customer complaints and escalated issues according to procedures.
- Maintained strict confidentiality of protected health Information to comply with HIPAA regulations.
- Verified and updated changes in patient, physician, or insurance to maintain proper billing.
- Scheduled appointments and assisted with referrals.
- Handled escalated calls professionally by listening carefully toneeds of each individual customer before offer appropriate solutions
- Navigated multiple computer systems and applications and utilized search tools to find information.
- Calculated premiums and established payment method.
- Prepared itemized statements, bills, and invoices, and record amounts due for items purchased and services rendered.
- Precisely evaluated and verified benefits and eligibility.
- Confidently and adeptly handled claim denials and/or appeals.
- Evaluated patients' financial status and established appropriate payment plans.
- Diligently filed and followed up on third party claims.
- Promptly sent out and posted all medical claims.
- Actively maintained current working knowledge of CPT and ICD-9 coding principles, government regulation, protocols and third party requirements regarding billing.
- Researched CPT and ICD-9 coding discrepancies for compliance and reimbursement accuracy.
- Posted and adjusted payments from insurance companies.
- Precisely completed appropriate claims paperwork, documentation and system entry.
- Reviewed and resolved claim issues captured in TES/CLAIMS edits and clearing house.
- Performed billing and coding procedures for ambulance, emergency room, impatient, and outpatient services.
- Managed collections claims for unpaid bills against estates of debtors.
- Verified insurance of patients to determine eligibility.
- Maintained and updated collections tracking spreadsheet to help organize payment information.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Collected payments and applied to patient accounts.
- Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
- Liaised between patients, insurance companies, and billing office.
- Posted payments and collections on regular basis.
- Adhered to established standards to safeguard patients' health information.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Filed and updated patient information and medical records.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Delivered timely and accurate charge submissions.
- Generated reports and analyzed trends to maximize reimbursement and reduce claim denials.
Medical Appointment Scheduler
MPF Federal
06.2017 - 04.2019
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Maintained confidentiality of patient information to comply with HIPAA regulations and protect patient privacy.
- Managed multiple schedules and prioritized tasks to meet demands of fast-paced work environment.
- Collaborated with healthcare staff to verify alignment of appointment scheduling with clinic protocols.
- Confirmed appointments one day prior to minimize missed appointments and maximize clinic utilization.
- Verified insurance coverage and eligibility for medical services prior to scheduling appointments to prevent billing issues.
- Followed up with patients to reschedule missed appointments.
- Managed complex calendars for multiple medical practitioners, verifying accuracy of all appointments.
- Developed and implemented efficient scheduling systems to maintain organized medical appointment schedules.
- Coordinated with other departments to facilitate seamless operation and excellent patient care.
Medical Claims Representative
UnitedHealth Group
10.2014 - 05.2017
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Verified patient insurance coverage and benefits for medical claims.
- Managed large volume of medical claims on daily basis.
- Researched and resolved complex medical claims issues to support timely processing.
- Evaluated medical claims for accuracy and completeness and researched missing data.
- Monitored and updated claims status in claims processing system.
- Used administrative guidelines as resource or to answer questions when processing medical claims.
- Identified and resolved discrepancies between patient information and claims data.
- Assessed medical claims for compliance with regulations and corrected discrepancies.
- Responded to correspondence from insurance companies.
- Followed up on denied claims to verify timely patient payment and resolution.
- Generated, posted and attached information to claim files.
- Checked documentation for accuracy and validity on updated systems.
- Reviewed provider coding information to report services and verify correctness.
- Maintained confidentiality of patient finances, records, and health statuses.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Airport Security Screener
TSA
12.2003 - 09.2014
- Connecting with Veterans to provide civilian doctor appointments
- Assisted clients in applying for public benefits such as Social Security Disability Insurance (SSDI) or
- Supplemental Security Income (SSI)
- Monitored eligibility and coverage of patients' insurance policies.
- Generated patient-specific letters for insurance companies to ensure accurate reimbursement of services.
- Answered telephones and directed calls to appropriate staff.
- Completed documents, case histories, and forms, such as intake and insurance forms.
- Explained partial and full denials for items not covered under policies.
- Conducted timely reviews of claims to ensure accuracy and completeness of documentation.
- Utilized appropriate job aids, knowledge and tools to process initial reception of claims.
- Reviewed insurance policy to determine coverage.
- Transcribed data to worksheets and entered data into computer for use in preparing documents and adjusting accounts
- Calculated premiums, refunds, commissions, adjustments and new reserve requirements, using insurance rate standards
- Involved persons to obtain missing information.
- Operated various security machinery and followed security procedures to ensure safety of all passengers aboard commercial airplanes
- Assisted international passengers with entering and exiting sterile security area
- Performed data entry of incident reports and answered multi-line phone during off peak times.
- Gave oral instructions to passengers to facilitate positive screening experience while maintaining safety and security
- Checked luggage or packages manually or with x-ray equipment to identify hazardous items.
- Monitored flow of passengers through screening checkpoints to facilitate orderly and efficient processing of passengers
- Utilized advanced imaging technology to screen passengers and accessible property moving through security checkpoints.
- Wrote reports of daily activities, property and equipment damage and unusual occurrences.
- Conducted carry-on and checked baggage searches to locate prohibited items such as weapons.
- Utilized chemical swab systems and explosive detection machines to test baggage for explosive materials.
- Performed pat-down or handheld wand searches of passengers triggering machine alarms to determine items warranting further investigation.
- Checked over [Number] passenger tickets per day to verify validity of each ticket.
- Authorized and monitored departure and entrance of visitors and employees to maintain security of premises.
- Conducted regular patrols of key areas to spot and control security concerns.
- Interacted with public to give directions, explain rules, and regulations and respond to inquiries.
- Attended daily briefings with supervisors to discuss issues with security screening processes.
- Used explosive detection machines and chemical swab systems to identify potential hazards.
- Developed and maintained positive rapport with passengers and other airport personnel.
- Operated x-ray machines, hand wands, and advanced imaging technology to conduct screening of passengers and baggage.
- Monitored security checkpoints for compliance with applicable security protocols.
- Maintained awareness and focus to identify potentially life-threatening objects or weapons of mass destruction.
- Responded effectively to security incidents and provided guidance regarding security procedures.
- Authenticated boarding passes, identification, and passports to prevent fraudulent travel.
Education
High School Diploma - General Studies Candidate
University of Alabama
Birmingham, ALNo Degree - General Studies
Faulkner University
Montgomery, AL01.2026
Skills
- Billing Procedure
- Customer Service and Assistance
- Healthcare Terminology
- Diagnostic Codes
- Quality Assurance Controls
- Web Portals
- Team Oversight
- Training Junior Team Members
- Call Centers
- Customer Service
- Past Due Account Management
- Quality Assurance Evaluation
- Online Chat
- Customer Interaction
- Knowledge Base
- Telephone Etiquette
- Writing Skills
- Effective Customer Communication
- Performance Feedback
- Special Requests
- Call Control
- Customer Education
- Queue Management
- Revenue Generation
- Customer Loyalty
- Team Goals
- Revenue Quotas
- Document and Records Management
- Live chat Messaging
- Customer Account Management
- Billing Adjustments and Refunds
- Patient Profiles
- Microsoft Office
- Problem Resolution
- Calm and Professional Under Pressure
- Research
- Documentation
Additional Information
- ADDITIONAL INFORMATION , Willing to relocate: Anywhere, Authorized to work in the US for any employer
Timeline
Chat Support Representative
Fetch Rewards
01.2022 - 05.2023
Medical Billing Representative
Evolent Health
05.2019 - 01.2022
Medical Appointment Scheduler
MPF Federal
06.2017 - 04.2019
Medical Claims Representative
UnitedHealth Group
10.2014 - 05.2017
Airport Security Screener
TSA
12.2003 - 09.2014
High School Diploma - General Studies Candidate
University of Alabama
No Degree - General Studies
Faulkner University
Similar Profiles
Denise BarreraDenise Barrera
L1 Support Customer Care Specialist at Fetch RewardsL1 Support Customer Care Specialist at Fetch Rewards
Joseph SempleJoseph Semple
Data Integrity Specialist at Fetch RewardsData Integrity Specialist at Fetch Rewards
Tamika WilsonTamika Wilson
Chat Support Specialist at Fetch RewardsChat Support Specialist at Fetch Rewards