Terriana Brown

• Handle high-volume inbound calls, chats, and account inquiries while meeting productivity and quality metrics

• Accurately process payments, account updates, and service changes in compliance with company policies

• Resolve billing discrepancies and explain account decisions clearly to customers

• Maintain detailed documentation and ensure data accuracy across internal systems

• Collaborate with team members to meet service level agreements and customer satisfaction goals

• Provided support for insurance policies, claims, warranties, and coverage inquiries

• Reviewed claim information, verified eligibility, and assisted with claim status updates

• Processed service requests, claim documentation, and account changes accurately

• Delivered empathetic customer service while handling escalated or complex claim inquiries

• Ensured compliance with regulatory guidelines and internal procedures

• Served as primary contact for healthcare providers regarding claims, benefits, eligibility, and authorizations

• Researched and resolved complex claims issues while ensuring adherence to payer policies and regulations

• Educated providers on proper claim submission, benefit interpretation, and policy requirements

• Documented all interactions thoroughly in claims systems to support audits and compliance

• Collaborated with claims, billing, and clinical teams to resolve issues efficiently

• Maintained HIPAA compliance and confidentiality standards at all times

• Reviewed, investigated, and adjudicated insurance claims to determine eligibility and coverage

• Rendered initial claim determinations based on policy guidelines and supporting documentation

• Calculated and issued claim payments accurately and within established timelines

• Communicated claim decisions clearly to policyholders and relevant parties

• Maintained detailed claim documentation to support audits, compliance, and quality reviews

• Resolved claim discrepancies while providing professional and customer-focused service