Operations Supervisor Service Representative

KATRICE DENSON

**** ********* *****, ********, ** 31907 · 706-***-****

*************@******.*** · www.linkedin.com/in/katrice-denson-1680974b

Motivated and customer service-oriented professional with a strong understanding of the importance of accurate claims processing. Adept at shifting priorities and bringing flexibility to dynamic situations. Follows policies, procedures, and guidelines to assure consistent quality. Maintains and ensures patient privacy and confidentiality.

EXPERIENCE

08/2022 – PRESENT

TRAVEL COUNSELOR/PLANNER, Travel Choice American Express Travel services

Temporary work assignment with the Compliance Regulatory Team that begun 02/2023-01/2024 Responsible for second level review, research and resolution on all assigned cases entered via the Global Complaints on CLIC system. Deliver extraordinary service and demonstrates ability to self-manage time and workload to achieve outstanding business results. Interact with Card Members to handle escalations and questions on complex case resolutions.

Research, plan, and carry out personalized travel experiences, through booking domestic and international flights, car, and hotel travel arrangements.

Communicate new and existing product offerings and value propositions relevant to the Card Member.

12/2021 – 08/2022

OPERATIONS SUPERVISOR, Broad Path Healthcare Solution

Supervised agents while taking calls for ESI Pharmacy Project.

Coached agents on their daily performance utilizing the Agent Metric.

While a training supervisor: ensured trainees were equipped with the information needed for success in production.

Ensured all policies and procedures were followed.

12/2020 – 12/2021

SUBJECT MATTER EXPERT, Broad Path Healthcare Solution

Managed the production chats by answering questions agents had while taking calls for ESI Pharmacy Project.

Assisted Work Force Management to ensure agents are in the correct status.

While a training SME supervisor: ensured trainees were equipped with the information needed for success in production.

Ensured all policy and procedures were followed.

EXPERIENCE CONTINUED

05/2020 – 12/2020

MEMBER SERVICE REPRESENTATIVE, Broad Path Healthcare Solution

Worked from home in a high call volume setting on the ESI Pharmacy Project while using strong customer service and conflict resolution skills.

Answered Plan Benefit questions from the commercial side of ESI Pharmacy while utilizing resources to ensure accuracy.

Maintained confidentiality of information for all members by adhering to privacy policies and HIPAA laws and guidelines.

Strong active listening skills and the ability to ask probing questions and understand concerns.

10/2018 – 05/2020

SUBSTITUTE TEACHER, Muscogee County School District

Served in the capacity of a substitute teacher / paraprofessional in the absence of the teacher.

Utilized appropriate procedures for student safety and welfare.

Managed the classroom and provided instruction according to plans as provided by the classroom teacher.

Helped students understand what they are to complete and uphold a positive learning environment.

05/2014 – 10/2018

RETIRED VETERAN, Columbus, GA

Volunteered at Waddell Elementary to help children read and write.

Assisted the local church with completing data entry and other clerical work.

Mentored 2 young adults and served as a positive role model.

EDUCATION

MAY 2019

ASSOCIATE OF SCIENCE – MEDICAL BILLING AND CODING, Ultimate Medical Academy

Fully accredited, accelerated program providing instruction in medical billing and ICD-10, CPT and HCPCS coding for diseases, surgeries, and medical procedures. Program content includes electronic health record (EHR) systems, accounting methods, and processes for preparing and submitting healthcare claims. Research, professional writing, critical thinking, and communications skills are emphasized throughout the program.

MAY 2009

BACHELOR OF ARTS – MANAGEMENT CONCENTRATION HUMAN RESOURCE MANAGEMENT, American Military University

Explored management theories, concepts, and practices necessary to organize, motivate, and lead human capital. Studied the laws, rules, regulations, policies, trends, and issues affecting both human capital in the workplace and the field of human resource management. Compared compensation packages and incentives used to recruit and retain employees. Included the selection, training, and development of employees, as well as performance appraisal and reward systems.

MAY 2006

ASSOCIATE OF SCIENCE – CLINICAL LABORATORY SCIENCE, George Washington University

Offers Army and Navy MLTs (Medical Laboratory Technicians) the opportunity to enhance their skills, obtain the credentials to pursue advanced study, and be eligible for promotion within the military. The Associate of Science (AS) in Health Sciences Laboratory Science for MLTs is a 75-credit hour degree program. Students use the 60 credits awarded for completion of the MLT undergraduate certificate and complete 15 credits of general education courses to complete the degree requirements. The general education requirements may be completed by taking coursework at a regionally accredited institution.

SKILLS

Electronic Health Records (EHR)

Payment Posting

Scheduling

HIPAA Compliance

Insurance Verification

Insurance Claim Processing

EOBs

Co-Payments

Deductibles

Manage Care (HMO, PPO, and POS)

Government Payers

Microsoft Office (Word, Excel, PowerPoint)

Outlook

Third Party Payers

Worker’s Compensation

Medical Billing

Medical Coding

ICD-9/ICD-10

HCPCS

CPT

Medical Terminology

Medicare

Medicaid and Tricare

CMS 1500

CMS 1450 (UB-04)

Fee Schedules

REFERENCES UPON REQUEST

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