Customer Service Insurance
Resume:
Stephanie Key
Clayton, NC
*********@*****.***
Work Experience
Charge Analyst –(Contract)
FastMed Urgent Care - Clayton, NC
January 2019 to April 2019
Communicating with customers with billing issues
Responsible for review of daily patient visits and documentation Ensure the reported accounts are received
Establish accurate procedure and diagnosis codes
Enter in the appropriate modifiers and any other additional data required by insurance companies
Responsible for answering incoming patient/clinic calls, email and skype messages
Claims Resolution Specialist – (Contract)
PFS Group - Morrisville, NC
April 2018 to January 2019
Assist patients and their insurance carriers to resolve open account balances.
Assess each account and take the appropriate actions necessary to obtain complete adjudication of
the patients claim.
Review an average of 70+claims per day.
Verifying insurance with carriers and deductible information for processing
Medicare Advantage Representative – (Contract)
BroadPath Healthcare Solutions
January 2018 to April 2018
Responsible primarily for inbound and outbound member inquiry calls
Exceptional customer focus and customer relations
Dedicated to client satisfaction and acts with customers in mind
Quality performance and results driven
Claims Processor – (Contract)
Beacon Healthcare Options - Morrisville, NC
June 2017 to November 2017
Process claims meeting department performance standards for production and quality for Medicare
Parts A & B.
Report claims adjudication and/or claims systems issue to management.
Proactively identify client service improvement opportunities, as appropriate.
Work in collaboration with the unit supervisors to resolve problems.
Contribute to a team environment by consistently exhibiting interpersonal skills and demonstrating
flexibility with daily operations/functions
Customer Service Professional
Blue Cross Blue Shield - Durham, NC
September 2016 to May 2017
Maintain membership records, both paper and electronic • Schedule the release of ID Cards, Member
Guides, and invoices • Process billing inquiries and reconciliation. Research billing errors and perform
or initiate reverse transactions as necessary, verify insurance to make sure that service was covered.
Research and respond to enrollment errors by telephone or in writing, communicate errors, corrective
actions being taken, and/or policies and procedures being enacted.
Receive and place telephone calls to answer questions or obtain information relating to membership
and enrollment, individual records. Handle billing and enrollment inquiries agents, benefits administrators, and members.
Process back-end error reports not related to electronic enrollment.
Benefits Advocate
United Healthcare - Morrisville, NC
September 2015 to September 2016
Reviewing ICD-9/10 coding for member to understand how they were billed for services
Submitted claims for review for corrections
Intervene with care providers (doctor's offices) on behalf of the customer to assist with appointment scheduling or connect with internal specialists for assistance when needed and verifying insurance to confirm that visit is authorized and covered.
Own problem through to resolution on behalf of the customer in real time or through comprehensive
and timely follow-up with the member • Research complex issues across multiple databases and work
with support resources to resolve customer issues and/or partner with others to resolve escalated issues
Provide education and status on previously submitted pre-authorizations or pre-determination requests
Benefits Service Center Specialist
Suntrust Bank Employees - Cary, NC
January 2013 to June 2015
Responds to telephone inquiries and complaints using standard scripts and procedures.
Research and provide information in reference to payroll checks and direct deposits via ADP.
Gathers information, researches/resolves inquiries and logs customer calls.
Providing assistance with payroll questions and processes.
Assisting with accessing ADP for information on pay checks • Assisting with Health and Welfare and
enrollment with various insurance carriers.
Education
BS in Accounting
Strayer University - Philadelphia, PA
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