Customer Service Insurance Verification
Resume:
Danielle Seymour
New Orleans, LA
********.*********@*****.***
www.linkedin.com/in/danielle-seymour-78010b189
SUMMARY
Dynamic, tech-savvy, and goal-driven professional with 8+ years of comprehensive background providing client-centered solutions. Skilled in customer service, high-volume calls, insurance verification, patient advocacy, and serving as a liaison between patients and providers and looking for an opportunity to apply my remote customer service skills to grow professionally.
WORK EXPERIENCE
Nile Health Remote
Remote Patient Care Coordinator June 2024 – Dec. 2024
•Received Inbound and placed outbound calls via Google Voice from/to patients, providers offices labs, pharmacies, and other individuals involved in patient care.
•Prepared, organized, submitted, and managed care documentation in electronic medical records and other internal tools including insurance verification.
•Worked collaboratively with team members following up and through on required tasks.
•Demonstrated knowledge of HIPPA regulations while maintaining patient information confidentiality while being compliant Received with internal policies and procedures.
Sentara Remote
Remote Insurance Verification Specialist/Patient Service Representative Sep 2023 – May 2024
•Efficiently liaised remotely with insurance carriers and internal eligibility teams to resolve data backlogs, ensuring accurate health insurance verification and meticulous documentation in spreadsheets.
•Executed manual system updates to reflect current health insurance enrollment and eligibility status, enhancing data integrity and system reliability.
•Conducted thorough verification of Coordination of Benefits (COB) and engaged in collaborative communication with carriers to address discrepancies, securing clean verifications.
Robert Half/LCMC Remote
Remote HRSA Member Billing Specialist Sep 2020 - Apr 2022
•Accurately remotely processed and submitted insurance claims for COVID-19 treatment and hospital services using the Epic system, ensuring timely reimbursement from both private and government payers for uninsured cases.
•Managed and prioritized large datasets, effectively filtering for time-sensitive COVID-19 cases to meet critical billing deadlines.
•Maintained up-to-date patient demographic information and provided daily reports on billing statistics to management through systematic email communications.
Kroger Specialty Pharmacy Hybrid
Patient Advocate Jul 2019 – Aug 2020
•Managed patient inquiries in a hybrid setting, guiding individuals through financial assistance options and community resources to subsidize prescription costs.
•Informed patients about various insurance plans, including Medicare Part D and Medicaid, and assisted with application processes to secure prescription coverage.
•Acted as the primary point of contact for incoming communications, maintaining therapy continuity and fostering trusting relationships with patients and healthcare providers.
TriWest Healthcare Alliance Harahan, LA
Patient Service Representative Jan 2016 - May 2019
•Liaison under the Veterans Administration to ensure accurate patient demographic information and facilitate effective communication with patients and specialty healthcare providers for the enrolled TriCare program Veterans.
•Managed timely acquisition of consult reports and responded to authorization requests, contributing to departmental efficiency and performance objectives.
•Supported training initiatives for new patient service representatives, enhancing team competency and ensuring adherence to documentation protocols.
EDUCATION
Strayer University-New Orleans
BA Business Administration/Health Care Administration Management, Business Administration
New Orleans, LA 2022-2026
Southeast College of Technology
AA Business Administration, Business Administration
Metairie, LA 1995-1997
SKILLS
Effective Communication • Problem Solver • HRSA Covid-19 Billing • Management / Patient Management • HIPPA Compliance • Insurance Verification • Medical Record Screening • Complex Authorization Specialist (CAS) • Patient Scheduling & Advocacy • Medical Record Review • Internal Auditing
REFERENCES AVAILABLE UPON REQUEST
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