YONIQUE FENTRESS
HAMPTON ROADS ,Virginia
Summary
Healthcare professional with extensive experience in claims review and customer service. Specializes in Medicare and Medicaid processes, effectively handling appeals and dispute resolutions to ensure compliance and accuracy.
Overview
31
31
years of professional experience
Work History
Reimbursement Analyst - Claims Analyst
ANTHEM
12.2016 - Current
- Investigate using administrative policies. Report results, render decisions for disputes
- Resolve deadlines & complete quality/ service agreements
- Write and send correspondence letters
- Track Follow up cases.
- Use various business applications Citrix,Facets,Macess,Nextgen, Outlook, Microsoft Teams, Excel, PowerPoint,Word
- Close completed work.
Technical Support
Contracted and non contracted
12.2008 - 12.2016
- Respond to chats, emails & phone calls.
- Troubleshoot & diagnose problems.
- Assist users with navigation on company’s website/mobile apps and portals. Resolve account, disputes, password resets, registration.
- Use analytical rationale to respond client/customer. Provide excellent customer service. Document account /case actions
Healthcare/Admin - Claims - HR Benefits Specialist - Medicare Specialist
EDS
12.2001 - 05.2008
- Calculate payout for eligible retirees. Determine payroll deductions for active employees.
- Coordinate commercial insurance with Commercial, Medicare/Medicaid/supplemental insurance
- Verify annual enrollment elected explain changes to health plan including qualifying life event changes.
- Mail forms to individuals, authenticate information for access to account info.
- Verify banking info for direct deposit financial institution.
Office Manager
HAMPTON INN & CALL CENTER MCI
12.1995 - 12.2001
- Enforce verbal and written disciplinary for coaching and corrective action plans.
- Train team, track attendance and hours worked
- Report to client.
- As Call Center Manager: Reported to Operations Director
- As Hotel Manager-Auditor :Reported to General Manager
- Prevent fraud
- Budget and Track office expenses.
- Evaluate annual Merit review
- Distribute payroll checks/stubs
Customer Support - Customer Service Rep
- All positions deliver customer service skills.
- Solve strategic problems and analyze recommendations.
- Established strong relationships with key stakeholders, customers, clients,partners.
- Forecast changes or trends
- Implemented eadership, insight and mentoring to employees of various company.
Education
NHA VA license - Medical Billing and Coding
01-2022
Associate of Science -
Tidewater Community
Norfolk, VA01-2015
Associate of Arts -
Tidewater Community
Norfolk, VA01-2014
Skills
- Team collaboration
- Healthcare industry
- Medicare - Medicaid expertise
- Appeals handling
- Claims review
- Technical Support
- Leadership
- Admin
- Call Center/Office
Keywords
- REIMBURSEMENT ANALYST
- CLAIMS REVIEW
- ADMIN
ADMIN
- MANAGER
- TECHNICAL SUPPORT
- CUSTOMER SUPPORT
- OFFICE
- INSURANCE
- MEDICARE SPECIALIST
- LEAD
- TRAINER
- COORDINATOR OF BENEFIT
References
Available upon request
Timeline
Reimbursement Analyst - Claims Analyst
ANTHEM
12.2016 - Current
Technical Support
Contracted and non contracted
12.2008 - 12.2016
Healthcare/Admin - Claims - HR Benefits Specialist - Medicare Specialist
EDS
12.2001 - 05.2008
Office Manager
HAMPTON INN & CALL CENTER MCI
12.1995 - 12.2001
Customer Support - Customer Service Rep
NHA VA license - Medical Billing and Coding
Associate of Science -
Tidewater Community
Associate of Arts -
Tidewater Community