Taylor Mckelphin
Buffalo,NY
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
8
8
years of professional experience
Work History
Claims Representative
Highmark Blue Cross Blue Shield
Buffalo, NY
07.2023 - Current
- Based payment or denials of medical claims upon well-established criteria for claims processing.
- Prepared and reviewed insurance-claim forms and related documents for completeness.
- Evaluated pending claims to identify and resolve problems blocking auto-adjudication.
- Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
- Assisted customers with inquiries about the status of their claims via telephone or email.
- Retained strong medical terminology understanding in effort to better comprehend procedures.
- Provided guidance on proper coding techniques for medical bills when necessary.
- Assisted claimants, providers and clients with problems or questions regarding claims.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Prepared detailed reports on trends in denials, rejections, appeals, collections.
- Collaborated with fellow team members to manage large volume of claims.
Medical Records Clerk
Ubmd Internal Medicine
Buffalo, NY
09.2022 - 07.2023
- Pulled patient charts for upcoming appointments.
- Resolved any discrepancies found in the review process.
- Retrieved medical charts for healthcare staff for filing in medical records.
- Organized patient charts, gathering medical histories, lab results and consents.
- Performed quality assurance reviews of medical records for accuracy and completeness.
- Conducted periodic audits of physical documentation versus electronic health records.
- Handled incoming calls and directed callers to appropriate department or employee.
- Processed incoming medical records requests.
- Maintained a secure filing system for confidential documents.
- Managed release of information requests and identified requestors as patient, relation or provider.
Customer Service Supervisor
Delta Airlines Global Services
Buffalo, NY
08.2021 - 09.2022
- Greeted passengers and provided information about departure and arrival times.
- Filed reports of passenger complaints or incidents that occurred during travel process.
- Coached staff on strategies to enhance performance and improve customer relations.
- Resolved customer complaints in a timely manner.
- Assisted customers with ticket purchases, trip planning, pricing and scheduling.
- Prepared daily activity reports detailing customer service issues encountered during shift.
- Delivered exceptional service to every customer through active engagement, effective listening and well-developed interpersonal skills.
- Communicated effectively with other departments to ensure the best customer experience possible.
- Worked with cross-functional teams to achieve goals.
- Maintained open communication with team members and stakeholders, resulting in successful project outcomes.
- Collaborated with cross-functional team to define features and build powerful and easy-to-use products and customer-facing workflow tools.
Customer Service Representative
Spectrum
Buffalo, NY
06.2021 - 08.2021
- Handled escalated customer service concerns to preserve customer satisfaction and maintain long-term business relationships.
- Met or exceeded call speed, accuracy and volume benchmarks on consistent basis.
- Managed customer expectations by clarifying needs, identifying options and recommending products and services.
- Provided customers with product and service information.
- Answered incoming calls and provided highest level of professionalism and knowledgeable service to every customer.
- Consulted with customers to resolve service and billing issues.
- Recommended improvements in products, service and billing methods to management to prevent future problems.
- Updated databases with new and modified customer data.
- Communicated courteously with customers by telephone, email, or chat systems.
Airport Operations Agent
Envoy Airlines
Buffalo, NY
06.2016 - 06.2021
- Coordinated with agencies to meet aircrew requirements for billeting, messing and refueling.
- Adjusted flight itineraries and communicated changes for optimal safety and flow of aircraft.
- Inspected aircraft cabins for cleanliness prior to departure of flights.
- Assisted with the boarding process, ensuring that all necessary documents were in order.
- Ensured compliance with aviation regulations and procedures concerning air carrier operations.
- Responded to emergent situations regarding flight operations or medical issues to quickly identify concerns, provide support and transport personnel and passengers away from critical scenes.
- Maintained records of flight arrivals and departures from the airport terminal.
- Facilitated communication between pilots and ground personnel during takeoffs and landings.
- Communicated with flight operations teams to coordinate cargo management and smooth flow of goods between hubs.
- Supervised airfield operations, including arrivals, departures and fueling, identifying and addressing concerns promptly to maintain targets.
- Prepared daily reports regarding operational issues encountered at the airport terminal.
Education
High School Diploma -
Riverside High School
Buffalo, NY06-2014
Skills
- Insurance Claims Review
- Database Management
- File Management
- Claims Investigation
- Data Analysis
- Inbound and Outbound Calling
- Data Entry
- Call Management
- Clerical Support
- Administrative Support
Timeline
Claims Representative
Highmark Blue Cross Blue Shield
07.2023 - Current
Medical Records Clerk
Ubmd Internal Medicine
09.2022 - 07.2023
Customer Service Supervisor
Delta Airlines Global Services
08.2021 - 09.2022
Customer Service Representative
Spectrum
06.2021 - 08.2021
Airport Operations Agent
Envoy Airlines
06.2016 - 06.2021
High School Diploma -
Riverside High School
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