Yolanda McDonald
Summary
Detail-oriented professional with extensive experience in healthcare claims processing and customer service. Adept at navigating complex insurance systems including Salesforce and Epic, ensuring accuracy and compliance with HIPAA regulations. Proven track record in improving process efficiency and solving intricate claim related issues, enhancing customer satisfaction and operational productivity.
Overview
11
11
years of professional experience
Work History
Claims Processor
Carelon (Beacon Health Options)
04.2019 - 10.2023
- Streamlined claims processing for behavioral health, enhancing authorization efficiency for various healthcare services.
- Spearheaded the resolution of complex claims issues, improving claim handling accuracy.
Customer Service Professional
Blue Cross Blue Shield of NC
05.2013 - 06.2017
- Delivered comprehensive support on benefits, eligibility, and claims to members and healthcare providers.
- Improved member satisfaction through effective communication and problem resolution.
Benefits Specialist
ACS/Xerox
06.2012 - 02.2013
- Assisted members with coverage inquiries and enrollment, ensuring a clear understanding of benefits and facilitating smooth access to healthcare services.
Education
Medical Billing/Coding/Office Information Management -
New Horizons Computer Learning Center
01.2011
CNA -
Richmond Community College
01.2007
Skills
- Claims resolution
- Compliance Adherence
- Problem Solving
- Data entry proficiency
- Customer Inquiry Handling
- Process Improvement
- Attention to Detail
Awards
Blue Cross Blue Shield of NC-Employee of the Month 2016
Accomplishments
- Valedictorian-CNA Training class at Richmond Community College (2007)
- Salutatorian-Medical Billing Coding/Healthcare Information Management (2011)
- Employee of the Month-Blue Cross Blue Shield of NC (2016)
References
References available upon request.
Timeline
Claims Processor
Carelon (Beacon Health Options)
04.2019 - 10.2023
Customer Service Professional
Blue Cross Blue Shield of NC
05.2013 - 06.2017
Benefits Specialist
ACS/Xerox
06.2012 - 02.2013
Medical Billing/Coding/Office Information Management -
New Horizons Computer Learning Center
CNA -
Richmond Community College
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