Umeka Walton
McKinney
Summary
Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation. Skilled at reviewing claims, sending for payment or reprocessing. Assisting members with locating providers, verifying provider network status. An established Insurance Verification Specialist known for handling various office tasks with undeniable ease. Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires and providing customized solutions to build loyalty.
Overview
13
13
years of professional experience
Work History
Healthcare Advisor | Claims Specialist
Arkansas Blue Cross Blue Shield
01.2020 - 04.2024
- Assist members with claims, benefit coverage, ID card and billing questions
- Assist providers with verifying benefits, policy questions, eligibility, claims, authorizations and verifying CPT/ICD-10 codes
- Phone work for long periods of time
- Assistance locating in network providers and evaluating claims
- Use of Microsoft Word, avaya, Ahin, Workday and other various insurance systems
- Documentation, research analyzing and problem-solving skills
- Ability to make decisions, adapt quickly
- Process requests, contact provider or facilities for members
- Provide first call resolution and concierge service
- Knowledge of medical terminology and ability to conduct research
- Routing inquiries, creating cases, ability to type effectively
- Follow up calls
- Working remote/ WFH experience
- Effective communication.
Risk and Research Management clerk
Centennial Bank
05.2018 - 01.2020
- Research and analyze check fraud
- Record keeping case
- Filing of paperwork
- Scanning, fax and email documents
- Process and prepare endorsement, altered checks, counterfeit and unauthorized remotely created check claims
- Recoup funds
- Order foreign currency for the region
- Process and prepare encode errors submitted by centennial bank employees using a ticketing system
- Process Canadian and foreign items for collection
- Work with Outlook, Bank Way system, Excel, Microsoft Word, Netlink and Image Center and other bank applications
- Process paid cases for duplicated checks
- Process adjustments through FED/ proper adjustment channel
- Data Entry
- Risk Management
- Crediting and Debiting customers’ accounts.
Bank Teller
Bank of America
03.2014 - 05.2018
- Customer service assistance
- Problem solving, solution provider, handling large amounts of cash, balancing accuracy
- Providing financial solutions
- Offer additional products and services
- Process payments, deposits and withdrawals for loans or checking and savings accounts
- Change Orders
- Processing night drop deposits for large businesses
- Cross-selling
- Offering additional products and services
- 10-key calculator
- Merlin Teller.
Customer service Assistant
AT&T Internet Services
08.2012 - 01.2014
- Assist customers with their internet
- Help customers get registered
- Assist customers with modem configuration, other departments and any other technical duties
- Provide customer service duties and technical assistance with internet, modem and computers
- Assist customers with registration, modem configuration, and other technical duties
- Troubleshooting and resolving the customers issue
- Documenting, note taking and track of cases.
CSOSA Day Reporting Center - Intern
06.2011 - 08.2011
- Customers of this business were ex-offenders
- Assisted customers in job search, resumes, housing, food, and clothing via telephone and in person
- Worked with SMART which is a system they use for keeping records on offenders at the DRC and excel to report statistics
- Facilitated several classes with the ex-offenders and wrote weekly reports.
Education
Master of Science Administration of Justice and Security -
University of Phoenix - Graduate
Bachelor in Humanities Social Sciences - Criminal Justice
Arkansas State University
Jonesboro, AR12.2011
Skills
- Healthcare management
- Quality Improvement
- Healthcare regulations
- Volunteer Management
- Client Engagement
- Data Entry
- Customer Relations
- Critical Thinking
- Active Listening
- Problem-solving abilities
- Customer Service
- Problem Resolution
- Call center experience
- Insurance Verification
- Medical terminology knowledge
- Appointment Scheduling
- Claims Processing
- Medical billing knowledge
- HIPAA Compliance
- Insurance Billing
- Team Leadership
Timeline
Healthcare Advisor | Claims Specialist
Arkansas Blue Cross Blue Shield
01.2020 - 04.2024
Risk and Research Management clerk
Centennial Bank
05.2018 - 01.2020
Bank Teller
Bank of America
03.2014 - 05.2018
Customer service Assistant
AT&T Internet Services
08.2012 - 01.2014
CSOSA Day Reporting Center - Intern
06.2011 - 08.2011
Master of Science Administration of Justice and Security -
University of Phoenix - Graduate
Bachelor in Humanities Social Sciences - Criminal Justice
Arkansas State University
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