Veronica Faulkenson
Norfolk,VA
Summary
Results-driven professional provides customers with tailored solutions to meet needs. Successfully establishes relationships with customers and delivers quality service. Agile individual with excellent communication and customer service skills. Adept Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims.
Overview
7
7
years of professional experience
2
2
years of post-secondary education
Work History
Medicare Relationship Manager
Health IQ
Norfolk, VA
03.2022 - 12.2022
- Achieved goals for sale of health and other ancillary products and services and exceeded performance metrics for customer service.
- Communicated regularly with clients to understand needs, evaluate current product use and cross-sell new products.
- Maintained a 95% quality score to date.
- Developed and cultivated lucrative relationships with both new and existing clients through effective communication and exemplary interpersonal skills.
Licensed Health Insurance Agent
Optima Health
Virginia Beach, VA
08.2021 - 12.2021
- Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
- Performed needs analysis to obtain information required to make appropriate health insurance product recommendations.
- Answered inbound calls from existing and future policyholders to answer inquiries and discuss insurance options.
- Collected premiums on or before effective date of coverage.
Loader/Unloader
Walmart Distribution Center
Williamsburg, VA
08.2019 - 01.2020
- Loaded, unloaded, and processed packages in an accurate and timely manner,
- Maintained a clean work environment to ensure safety and compliance with company guidelines
- Ensured freight quality and integrity
- Worked cooperatively in a fast-paced environment to meet established timelines.
Life Insurance Sales Agent
Sutherland Global Services
Chesapeake, VA
05.2018 - 07.2019
- Customized existing insurance programs to meet the needs of individual clients by analyzing specific requirements
- Consulted individuals interested in purchasing insurance coverage taking 500 inbound sales calls per week
- Exceeded sales target of 45k at 95k in monthly premium.
- Sought out new clients and developed client relationships through networking, direct referrals, lead databases, and cold calling.
Customer Service Representative
Conduent
Chesapeake, VA
09.2017 - 11.2017
- Handled 50+ customer interactions per day, giving detailed, personalized, friendly, and polite service to ensure customer retention and satisfaction
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Provided primary customer support to internal and external customers.
- Clarified customer issues and determined root cause of problems to resolve product or service complaints.
Claims Associate
Sutherland Global Services
Chesapeake, VA
03.2017 - 08.2017
- Conducted research to address claim issues, which resulted in the timely payment of member claims
- Collected pertinent information to assist with medical necessity evaluation
- Maintained 85% claims resolution
- Analyzed and addressed escalated claims to resolve issues quickly.
- Examined reports, accounts, and evidence to determine integrity and accuracy of information.
- Generated explanation of benefits , posted and attached information to claim files.
- Compiled and tracked outstanding balances owed to medical facilities.
Customer Service Agent
Nexxlinx
Jacksonville, NC
08.2016 - 02.2017
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Communicated with clients regarding account services, statements, and balances.
- Entered customer interaction details in sales system to track requests, document problems, and record solutions offered.
- Memorized entire line of company products and services, including prices and special discounts
Customer Service Representative
Alorica
Jacksonville, NC
06.2016 - 08.2016
- Provided primary customer support to internal and external customers in a fast-paced environment
- Assisted AMEX Credit card holders and members with point redemption and credit card payments
- Handle 80+ calls daily, with duties including signing up new customers, retrieving customer data, presenting relevant product information, and canceling services
- Clarified customer issues and determined root cause of problems to resolve product or service complaints.
Customer Service Representative
Convergys
Jacksonville, NC
09.2015 - 07.2016
- Assisted FedEx Customers with tracking and label creation information.
- Set appointments, shipping, and special order requests, and arranged merchandise pick-ups.
- Exceeded quantitative metrics on customer satisfaction, customer retention, and inquiry volume
- Promptly handled an average of 60-70 customer inquiries and complaints per day with a 90% customer satisfaction rate
Education
Associates of Science - Medical
Ultimate Medical Academy
03.2020 - 03.2022
Skills
Medicare and Medicaid processes
CMS complianceClaim forms CMS 1500, CMS 1450 (UB-04)CPT codingHCPCSAnatomy knowledgePhysiology knowledgeMedicare Supplements
Medical terminologyInsurance verificationEHR systemsEMR systemsHIPAA compliance and certificationCustomer serviceCustomer supportCustomer retentionCustomer relationship managementInsurance SalesMedical BillingInside SalesSalesforceMedical RecordsSlack
Microsoft Outlook
Microsoft TeamsOrganization
Time management
Multitasking
Medical insurance claims
Complaint resolution
Additional Information
- Health Insurance License ; NPN: 18796004
- Ultimate Medical Academy – HIPAA Essentials for Healthcare Professionals Certificate.
- Microsoft Office Applications – Word, Excel, and PowerPoint | Type 35 WPM.
- Internet speed as of 02/19/2023- DL-290.89,UL-9.92
Timeline
Medicare Relationship Manager
Health IQ
03.2022 - 12.2022
Licensed Health Insurance Agent
Optima Health
08.2021 - 12.2021
Associates of Science - Medical
Ultimate Medical Academy
03.2020 - 03.2022
Loader/Unloader
Walmart Distribution Center
08.2019 - 01.2020
Life Insurance Sales Agent
Sutherland Global Services
05.2018 - 07.2019
Customer Service Representative
Conduent
09.2017 - 11.2017
Claims Associate
Sutherland Global Services
03.2017 - 08.2017
Customer Service Agent
Nexxlinx
08.2016 - 02.2017
Customer Service Representative
Alorica
06.2016 - 08.2016
Customer Service Representative
Convergys
09.2015 - 07.2016