Summary
Overview
Work History
Education
Skills
Websites
Certification
Timeline
Generic
Wendi Garcia

Wendi Garcia

Haughton,LA

Summary

Highly motivated and organized insurance agent with 20+ years of experience in Medicare, Commercial and Exchange lines of business.

Overview

30
30
years of professional experience
1
1
Certification

Work History

MEMBER SERVICES AUDITOR

Blue Cross Blue Shield Of Louisiana
Monroe, LA
09.2003 - 02.2024
  • Audio verify calls from MSR, live or recorded, in order to assess compliance with protocols and quality parameters as set forth by CMS
  • Daily feedback, and or education is given to MSR in areas that require improvement
  • Maintain Customer Satisfaction/Retention
  • Assisting on education to members on plan information
  • Research billing issues
  • Filing Grievances/refer unresolved grievances to designated department for further investigation
  • Quoting of Benefits to members/providers
  • Assisting in call queue when needed
  • Assist with premium payments
  • Assisting with updating Policy & Procedures as needed

Insurance Verification Specialist

Gastroenterology Clinic
Monroe, LA
06.1996 - 04.2001
  • Verified insurance.
  • Collected copays and deductible/coinsurance at the time of check in
  • Kept family members updated on the progress of the procedures/recovery
  • Posted payments
  • Made bank deposits
  • Obtained authorizations on all of my patients that required authorizations.
  • Scheduled follow up appointments at the clinic.

Claims Processor

American Medical Response, AMR
Monroe, LA
01.1994 - 09.1997
  • Run tickets would be given to us by the paramedics and it was up to us to read the narrative of the call and file the claim with appropriate ICD9 and CPT coding.

* I then moved to Accounts Payable at the same company and paid the bills for our substations. Was in charge of making sure that all bills were paid timely, Purchase Orders were approved before anything was bought. Worked closely with the Field Supervisor to ensure all DMV information stayed updated on all running units.

* Worked back up as a receptionist for lunch time and breaks.

Ordered all uniforms for medics.

Education

High School Diploma -

West Monroe High School
West Monroe, LA
05.1989

Pharmacy -

University of Louisiana At Monroe
Monroe, LA

Skills

  • Audio verification
  • Compliance assessment
  • Quality assurance
  • Customer satisfaction
  • Customer retention
  • Education and training
  • Billing issue research
  • Grievance filing
  • Benefits quoting
  • Call queue assistance
  • Premium payment assistance
  • Policy and procedure updating
  • Insurance confirmation
  • Compliance standards
  • Time management
  • Internal auditing

Certification

  • Louisiana Life Health & Accident Insurance License
  • Louisiana Property & Casualty License
  • Texas Property & Casualty License

Timeline

MEMBER SERVICES AUDITOR

Blue Cross Blue Shield Of Louisiana
09.2003 - 02.2024

Insurance Verification Specialist

Gastroenterology Clinic
06.1996 - 04.2001

Claims Processor

American Medical Response, AMR
01.1994 - 09.1997

High School Diploma -

West Monroe High School

Pharmacy -

University of Louisiana At Monroe
Wendi Garcia