TRACEY GATLING
Forney,TX
Summary
Reputable customer service professional brings strong phone speaking skills paired with in-depth knowledge of CRM systems. Offers vast experience connecting customers with products and services. Punctual and responsible, Known for successfully handling escalated customer support issues.
Overview
10
10
years of professional experience
Work History
Patient Intake Specialist
Blue Cross Blue Shield of NC
Durham, NC
11.2021 - Current
- Provide clinical review outcome notification to members and providers (verbal and written)
- Complies with timeliness standards and reduces unpaid claims and rework by accurately processing requests. May also assist on special projects as needed.
- Document all pertinent information related to the call/inquiry, attach supporting information as applicable and if unable to resolve route to appropriate area for follow up as applicable.
- Submit inpatient/outpatient authorization per HCPCS/CPT Codes.
Expense Sharing Support/Claims Specialist
OneShare Health
Irving, TX
11.2019 - 11.2021
- Researched and reviewed information to determine validity of insurance claims and contacted companies and customers about decisions.
- Mentored and trained new hire employees in resolving complex liability disputes and policy analysis.
- Communicated with other departments to establish action plans and manage open claims to closure.
- Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
Credit Card Fraud Analyst
Neiman Marcus Group, Inc
Dallas, TX
05.2016 - 11.2019
- Communicated with customers and company personnel, utilizing active listening and interpersonal skills.
- Reviewed, verified and identified customer transactions to detect and prevent financial crimes activities.
- Performed general accounting handling functions such as closing accounts and placing accounts on hold.
- Maintained files, records, databases and prepared routine management reports.
Customer Service and Operations Analyst
Kohl's
Dallas, TX
09.2013 - 03.2016
- Gathered and organized data to analyze current industry trends.
- Analyzed and tracked data to prepare forecasts and identify trends.
- Explained technical concepts to non-technical staff members in easy to understand language and concepts.
- Met end-user goals by supporting strategic planning initiatives for applications.
Education
Associates - Health Services Administration
University of Phoenix
Tempe, AZ05.2016
Skills
- Pre Authorizations
- Senior Leadership Support
- Risk Management
- Medical Terminology
- Pre Authorizations
- Medical Claim Processing
- Supervision & Leadership
- Customer Service
- Multitasking
- Problem Resolution
- Insurance Verification
- Data evaluation
- Fraud Investigations
- Microsoft Office expertise
Timeline
Patient Intake Specialist
Blue Cross Blue Shield of NC
11.2021 - Current
Expense Sharing Support/Claims Specialist
OneShare Health
11.2019 - 11.2021
Credit Card Fraud Analyst
Neiman Marcus Group, Inc
05.2016 - 11.2019
Customer Service and Operations Analyst
Kohl's
09.2013 - 03.2016
Associates - Health Services Administration
University of Phoenix
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