Te-Aria Mahaney
Urbandale,IA
Summary
Personable and dedicated customer service representative with extensive experience in industry. Solid team player with upbeat, positive attitude and proven skill in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses.
Overview
10
10
years of professional experience
Work History
Insurance Denial Specialist
Iowa Ortho
Des Moines, US
01.2026 - 06.2026
- Review and analyze medical insurance claims denied for payment, investigate the reasons for denial and coordinate with various departments to correct the claim.
- Liaised with healthcare providers and insurance companies to facilitate claim resolution, identified trends in denials, and recommended strategies to mitigate future occurrences.
- Resolved denied claims as insurance denial specialist, enhancing overall claims processing.
- Ensure compliance with healthcare regulations, medical codes, and insurance policy requirements.
- Maintain accurate and up-to-date records of all denied claims and their resolutions.
- Trained staff on preventing claim denials and utilizing software systems like NextGen, OPT, and EHR for tracking and managing denied claims.
Customer Service Experience
EMC Insurance
Des Moines, US
10.2024 - 10.2025
- Processed payments, managed customer correspondence, and resolved inquiries for life and workplace insurance policies and annuities.
- Identified areas where clients could improve their customer service experience through technology enhancements.
- Collaborated with other departments to ensure seamless customer service experience.
- Formulated strategies for increasing sales through enhanced customer service experience.
New Business Representative
ATHENE
West Des Moines, US
01.2023 - 10.2024
- Processed and distributed communications, including texts, applications, and images for annuity contracts, ensuring timely delivery and compliance with procedures.
- Scanned images, sent and received documents, organized paper and electronic files, and analyzed communication processes to enhance workflow efficiency.
- Adhered to company policies in handling materials, particularly those containing confidential information, maintaining data integrity and security.
Billing Specialist
Radiant Complexions Dermatology Clinics
West Des Moines, US
10.2021 - 01.2023
- Review bills, post and create claims to send to insurance.
- Reviewed invalid claims from clearing house and resolved issues promptly.
- Review Rejected claims from the insurance payers and handle accordingly.
- Post insurance payments from ERA file and paper EOB's.
- Perform claims follow-up by working aged balances in accordance of timely filing deadlines.
- Coordinate re-submission of claims to payers electronically or via mail with coding and billing department personnel.
- Processed denials in denial queue, ensuring accurate resolution based on claim information.
- Submits appeals with supporting documentation when situation warrants such action.
- Identifies denial trends and works with insurance payers to resolve issues.
- When situation warrants, enlists support of a supervisor in escalating issue/ concern.
- Ensures process issues (i.e. incorrect data entry upon patient registration) resulting in denials and/or claim delays are brought to the clinic's attention to bring about necessary process changes.
- Organized daily activities to meet and achieve established collections goals.
- Works with supervisor to develop action plans to effectively deal with identified issues.
- Shares updated information from insurance payers to assist in ongoing training of department personnel.
- Works credit balances related to insurance payers by notifying payers that suspected overpayments exist, obtaining refund request letters from payers, filling out refund request forms and pulling supportive documentation.
- Actively observes standards of conduct and participates in compliance program.
Senior Account Manager
Marsh & McLennan Companies
Urbandale, US
08.2020 - 09.2021
- Built and maintained client relationships to deliver best-in-class service, driving client growth and retention.
- Served as primary client contact for day-to-day needs, addressing inquiries to enhance overall client experience.
- Perform critical client functions, including: evaluating risks; developing solutions; articulating impact of options; leveraging prepared analytics and making recommendations to client across supported product line.
- Collaborated with external and internal partners to gather and relay customer feedback for service improvement.
- Manage and record all activities in the workflow system to ensure timely follow up by client, carriers, client team and delivery of final policy.
- Monitored changing market conditions to stay informed about trends. and understand and comply with all compliance, professional and transparency standards to better serve clients.
Member Advocate
ClaimDOC
Des Moines, US
01.2016 - 08.2020
- Developed and implemented four-week Member Advocate orientation and training program to enhance onboarding experience.
- Educated incoming employees, including Account Managers, on fundamentals of insurance, medical claims, and reference-based medical claim pricing to ensure compliance and understanding.
- Draft training and reference materials for current Member Advocates.
- Conduct Quality Assurance checks on current employees, followed by training and coaching.
- Resolved complex and high-level issues to improve member satisfaction and streamline processes.
- Solely designed and managed company's Balance Bill Defense.
- Drafted legal templates for Balance Bill disputes.
- Trained and managed Balance Bill team and handled complex balance bill issues.
- Advise medical providers regarding claim appeal process and plan payment methodology.
- Coordinate provider outreach calls to explain self-funded, open-access medical plans and secure their office's acceptance for our members.
- Negotiate contracts with Directors for major Health Systems across the country.
Timeline
Insurance Denial Specialist
Iowa Ortho
01.2026 - 06.2026
Customer Service Experience
EMC Insurance
10.2024 - 10.2025
New Business Representative
ATHENE
01.2023 - 10.2024
Billing Specialist
Radiant Complexions Dermatology Clinics
10.2021 - 01.2023
Senior Account Manager
Marsh & McLennan Companies
08.2020 - 09.2021
Member Advocate
ClaimDOC
01.2016 - 08.2020