Valerie Perry
Kernersville,NC
Summary
Highly-motivated employee with desire to take on new challenges. Proficient in medical and dental terminology. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
31
31
years of professional experience
Work History
Customer Service Representative
Elevance Health-Carelon RX
Winston-Salem, N.C.
07.2023 - Current
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
- Provided customer service to patients and healthcare providers, answering questions related to prior authorization .
- Identified reasons behind denied claims with an approved prior authorization on file.
- Communicated authorization decisions, including approvals and denials, to healthcare providers and patients.
- Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
- Answered questions and responded to inquiries to deliver high level of service to patients.
- Reviewed and processed prior authorization requests for infusions and medications according to established guidelines.
- Assisted healthcare providers with denied authorizations, including gathering additional information and documentation.
- Coordinated with healthcare providers to gather necessary patient information for prior authorization requests.
Customer Service Representative/Cruise Specialist
Norwegian Cruise Line
Tampa, FL
05.2022 - 06.2023
- Answered customer inquiries and provided accurate information regarding products and services.
- Developed positive relationships with customers through friendly interactions.
- Maintained detailed records of customer interactions, transactions and comments for future reference.
- Identified opportunities for upselling additional products or services based on customer needs.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Maintained a high level of professionalism when dealing with difficult customers.
- Remained calm and professional in stressful circumstances and effectively diffused tense situations.
- Asked probing questions to determine service needs and accurately input information into electronic systems.
- Informed customers about billing procedures, processed payments, and provided payment option setup assistance.
Customer Service Representative
Carolina Basement Systems
Winston-Salem, NC
05.2021 - 02.2022
- Identified opportunities for upselling additional products or services based on customer needs.
- Answered customer inquiries and provided accurate information regarding products and services.
- Resolved customer complaints promptly and efficiently.
- Answered customer inquiries through live chat and email in a timely manner.
- Maintained records of customer interactions and transactions.
- Managed incoming calls to schedule appointments and answer questions.
Medical Claims Processor
Aetna(CVS)
Greensboro, NC
09.2019 - 02.2020
- Processed a high volume of claims on a daily basis using established time frames.
- Attended meetings and seminars related to healthcare industry updates.
- Performed Quality Assurance checks on processed claims ensuring all edits were resolved prior to submitting them for adjudication and payment.
- Researched claim denials and appeals to determine appropriate resolution.
- Investigated discrepancies in medical billing information such as incorrect codes or amounts due.
- Evaluated pending claims to identify and resolve problems blocking auto-adjudication.
- Administered standard contract benefits to process pending claims for dental benefits.
Front Office Manager
Machine and Welding of Danbury
Walnut Cove, NC
05.2017 - 09.2019
- Provided leadership to ensure that all Front Office team members are delivering excellent customer service.
- Assisted in recruiting, training, evaluating and developing staff members in order to maintain high standards of performance.
- Responsible for managing the daily operations of the front office, including greeting guests, answering phone calls and emails.
- Maintained accurate records of financial transactions such as cashiering activities, credit card charges.
- Established strong relationships with corporate clients in order to foster repeat business opportunities.
- Assisted with interviewing job applicants by asking appropriate questions and offering insight and feedback.
Medical Claims Representative
Emcsolutions
Oak Ridge, NC
09.2015 - 04.2017
- Managed a high volume of incoming calls from providers seeking assistance with submitting claims.
- Performed quality assurance checks on submitted claims prior to final processing.
- Assessed patient information, submitted documents, and other data to identify coding errors or omissions.
- Resolved customer inquiries regarding claim status, payment issues, billing disputes.
Dental Assistant/Front Office Assistant
Dr. Daniel Hobbs, D.D.S.
Greensboro, NC
06.1993 - 06.2004
- Kept accurate records of dental treatments provided for each patient's visit.
- Helped maintain inventory levels of all dental supplies used in day-to-day operations.
- Conducted routine maintenance of equipment used in dentistry operations.
- Performed administrative duties such as scheduling appointments, answering telephones and updating patient records.
- Prepared dental materials such as amalgam, composite resin, impression material and cements for use by the dentist.
- Educated patients on proper oral hygiene techniques and habits.
- Greeted patients upon arrival at the office and escorted them to an examination room.
- Assisted dentist in providing dental treatment to patients, including taking patient medical histories and vital signs.
- Handled billing inquiries from insurance companies regarding claims submitted by the office.
- Took digital X-rays of teeth using radiographic equipment.
- Reviewed patient charts prior to visits to ensure that all relevant information was available for the doctor's review.
- Fabricated temporary crowns or bridges from impressions taken by the dentist.
- Assisted in laboratory procedures such as mixing impression materials or pouring casts from impressions taken by dentists.
- Documented patient records with procedures performed and added notes taken to charts.
- Resolved discrepancies between insurance companies and patients regarding payments, fees, and benefits.
Education
Dental Assisting -
Guilford Technical Community College
Jamestown, NC08-1993
High School Diploma -
Robert B Glenn High School
Kernersville, NC05-1991
Skills
- Data Collection
- Inbound and Outbound Calling
- Customer Service
- Computer Proficiency
- Critical Thinking
- Researching
- Claims Investigation
- Problem-Solving
- Insurance terminology
- Background in insurance
- Claims Processing
- Medical terminology proficiency
- Insurance claims processing
- ICD-10 Coding
- Dental terminology knowledge
Timeline
Customer Service Representative
Elevance Health-Carelon RX
07.2023 - Current
Customer Service Representative/Cruise Specialist
Norwegian Cruise Line
05.2022 - 06.2023
Customer Service Representative
Carolina Basement Systems
05.2021 - 02.2022
Medical Claims Processor
Aetna(CVS)
09.2019 - 02.2020
Front Office Manager
Machine and Welding of Danbury
05.2017 - 09.2019
Medical Claims Representative
Emcsolutions
09.2015 - 04.2017
Dental Assistant/Front Office Assistant
Dr. Daniel Hobbs, D.D.S.
06.1993 - 06.2004
Dental Assisting -
Guilford Technical Community College
High School Diploma -
Robert B Glenn High School
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