Claims Processing Leader with 19+ Years of Experience

Megan Knotts

Claims Processor Customer Service Advocate

**** *** *** · Parkersburg, WV 26101 · 304-***-**** · ***********@*****.***

Professional Summary

Dedicated and experienced Customer Service and Claims Processing professional with over 19 years at Highmark Blue Cross Blue Shield. Proven record of excellence in claims accuracy, productivity, and team support. Known for reliability, leadership, and compassionate communication when assisting members and colleagues.

Key Skills

• Claims processing and verification

• Customer and member service excellence

• Research and account reconciliation

• Training, coaching, and mentoring staff

• High accuracy and productivity (99.95% quality, 141% production rate)

• Policy interpretation and implementation

• Written and verbal correspondence

• Independent problem-solving

Professional Experience

Highmark Blue Cross Blue Shield – Parkersburg, WV

Claims Processor September 2014 – Present

• Perform extensive research and analysis of claims to ensure accuracy and compliance.

• Adjust and process complex or high-priority claims independently.

• Apply departmental regulations, written procedures, and technical manuals.

• Resolve issues with minimal supervision, consulting management only when necessary.

• Handle complex cases requiring investigation, original thinking, and judgment.

Highmark Blue Cross Blue Shield – Parkersburg, WV

Lead Support Specialist June 2011 – September 2014

• Served as liaison between staff and management regarding new policies and updates.

• Provided coaching and feedback to team members to improve accuracy and performance.

• Ensured all processed transactions met compliance and security standards.

• Assisted in developing and implementing updated training materials and guidelines.

Highmark Blue Cross Blue Shield – Parkersburg, WV

Senior Customer Service Representative May 2008 – June 2011

• Verified accuracy of processed transactions and member benefits.

• Resolved member inquiries by phone and written correspondence.

• Ensured all communications were professional, accurate, and compliant with company standards.

• Researched and corrected payment and billing issues promptly.

Highmark Blue Cross Blue Shield – Parkersburg, WV

Customer Service Representative April 2005 – May 2008

• Managed member inquiries and billing transactions with efficiency and professionalism.

• Conducted detailed research on accounts to resolve discrepancies.

• Processed member payments and updates accurately within automated systems.

• Demonstrated reliability and strong time management, maintaining punctuality and minimal supervision.

Education

High School Diploma or Equivalent

Professional Highlights

• Consistently exceeded production goals, achieving 141% productivity.

• Maintained 99.95% accuracy in claims processing.

• Recognized for leadership, dependability, and exceptional customer care.

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