Customer Service Data Entry

LASHAWN HOLCOMB

CLAIMS ANALYST

313-***-**** **************@*****.*** Warren, MI 48091

PROFESSIONAL SUMMARY

Highly motivated examination professional with 10+ yrs experience in the insurance industry. Proven track record of efficiently processing a high volume of claims while ensuring accuracy and compliance. Excellent problem-solving and communication skills with a commitment to providing superior customer service. Experienced in working with complex medical and legal documents, and utilizing multiple computer systems to maintain accurate records. Boasting a proven track record at Health Alliance Plan, adept in claims analysis and resolution, and excelling in active listening and communication. Skilled in data entry and technical support, consistently achieving and surpassing company goals.

SKILLS

Call Management

Data Entry

Scheduling

Product Knowledge

Data Collection

Report Generation

Complaint resolution

Technical Support

Follow-up skills

Complaint Handling

Active Listening

Multi-line phone talent

Claims review

Document workflow

Dispute tracking

Claims analysis

Policy Interpretation

Regulatory Compliance

EXPERIENCE

CUSTOMER SERVICE REPRESENTATIVE Health Alliance Plan

Troy, MI

April 2016 - Present

Handled customer complaints and inquiries in a courteous and efficient manner.

Demonstrated excellent communication skills, both verbal and written, in order to effectively interact with customers.

Analyzed competitive landscapes, assisted with designing customer service visions, and handling complex administrative responsibilities.

Recommended improvements in products, services or billing methods to prevent future problems and generate revenue growth pathways.

Processed claims for Health Alliance Plan and various Henry Ford affiliated networks.

Claims include Medicaid/Medicare HAP Empowered and Trusted Health Plan Government Programs;

HMO/PPO Medicare Advantage (MA) Insurance plans and various other commercial insurance plans.

Investigate all provider inquiries

and complaints and appropriately educate providers on corporate policy and/or procedures.

BENEFITS ADVISOR Dialog Direct

Troy, MI

January 2015 - April 2016

Researched best practices from other organizations in order to make recommendations for changes or enhancements to the company's existing benefits plans.

Maintained up-to-date knowledge of state and federal laws governing employee benefits plans.

Provided customer service to assist with benefit inquiries and requests, demonstrating excellent communication and problem-solving skills.

Identified opportunities for cost savings within the company's existing portfolio of benefits programs.

Collaborated closely with management teams to create high standards and promote department leadership.

Assisted with coordinating, scheduling an d other office administrative duties as assigned.

Coding and resolving pending claims with the knowledge of ICD9

IDC10 Coding.

Processed claims adjustments from the system to correct processing discrepancies by reviewing internal system while

applying HIPPA Policies & Procedures.

REFERENCES

References available upon request.

AWARDS

Voted Manager of the year for coaching quality skill set and accuracy on AHT.

Awarded first place for 100% of team attendance for 6 months straight in a calendar year.

Named Manager of the quarter for employees on the move incentive.

Repeatedly placed in the top 5% of teams for ERP and FCR.

CERTIFICATIONS

Certified Notary Public

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