Vanitria Stewart
Natchitoches,LA
Summary
Knowledgeable Senior Claim Benefit Specialist seeking new opportunities. Proven expertise in managing complex claims, resolving disputes, and ensuring compliance with regulatory standards. Demonstrated proficiency in analytical problem-solving and effective communication.
Overview
11
11
years of professional experience
Work History
Customer Service Associate
Modivcare
08.2023 - 06.2025
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Handled customer complaints professionally, resulting in satisfactory outcomes and positive feedback.
- Maintained a high level of product knowledge, providing accurate information to customers.
- Answered customer telephone calls promptly to avoid on-hold wait times.
Technical Support Representative
Transcom
12.2020 - 03.2023
- Provided remote assistance to customers experiencing technical difficulties, guiding them through step-by-step resolutions with patience and professionalism.
- Managed challenging customer situations with diplomacy and professionalism, often turning negative experiences into positive outcomes.
- Collaborated with cross-functional teams to identify recurring issues, developing proactive solutions to minimize future occurrences.
Senior Claims Benefit Specialist
Foundever
12.2014 - 10.2020
- Analyzed complex claims to ensure accurate benefit determination and compliance with industry regulations.
- Led cross-functional teams to streamline claim processing workflows, enhancing overall operational efficiency.
- Applies medical necessity guidelines, determines coverage, completes eligibility verification, identifies discrepancies, and applies all cost containment. measures to assist in the claim adjudication process.
- Handles phone and written inquiries related to requests for pre-approval/pre-authorization, reconsiderations, or appeals
Education
High School Diploma -
Natchitoches Central High School
05-2013
Skills
- Claims management expertise
- Critical thinking capacity
- Attention to detail and accuracy
- Superior organizational skills
- Medical terminology mastery
- Proficient in claims software
- Multitasking and prioritization
- Teamwork and collaboration
- Customer service
- Exceptional interpersonal skills
- Financial analysis
- Claims analysis
Languages
English
Native or Bilingual
Timeline
Customer Service Associate
Modivcare
08.2023 - 06.2025
Technical Support Representative
Transcom
12.2020 - 03.2023
Senior Claims Benefit Specialist
Foundever
12.2014 - 10.2020
High School Diploma -
Natchitoches Central High School