Customer Service & Insurance Professional Expert
Resume:
Tonya Denene Alston
Covington, Tennessee 38019
*************@*****.***
OBJECTIVE: Seeking a challenging position to utilize my 10+ years of customer service and insurance experience.
SKILLS: 10 key, typing (55 wpm), answering phone, filing, faxing, scheduling appointments, Microsoft office, excel, insurance verification, insurance prior authorizations, ICD 10 codes, CPT codes, meeting month end deadlines, processing monthly hospital report, Payroll, processing travel claims, making car rental and hotel reservations for officers and other duties assigned, interpersonal savvy, communicates effectively, demonstrates self-awareness and manages complexity.
EDUCATION: Covington High School, 803 S. College St, Covington, TN 38019. Diploma received May 20, 1988.
Employment History:
01/2025 – Present Tennessee Dept. of Corrections: Account Clerk- Duties: Calculates overall invoice totals, generate reports, reconciles physical inventory against electronic inventory data, communicates with internal and external customers in a friendly and courteous manner, travel to external site (bank) for bank deposits, maintain paper files (court orders) as required to meet record keeping requirements, advise new hires about benefit enrollment (selecting benefits), benefits orientation.
11/22- Oct 23 BCBSMA: FEP Member Service Rep- Duties: Answer calls from federal employees advising them of their health benefits, explaining EOB’s, reaching out to providers about coding, reaching out to collection agencies about past due accounts that have been paid, helping members understand benefits (copays, coinsurance’s, deductibles and out of pockets limits), ordering ID cards and benefits catalogs, researching old claims, resubmitting claims for reprocessing. Researching claims, determining eligibility and benefits, advising member why a claim was not paid, following up with provider to see why they billed a certain way, following up with member if issue was not resolved on first call and advising member of seminars being held to help with retirement, benefits and other questions they may have.
08/16 – July 22 Conifer Health Solutions: Patient Access Rep III- scheduling outpatient diagnostic testing, insurance verification, obtaining prior authorizations, financial counseling, scheduling outpatient PT and OT, meeting month end deadlines, obtaining signatures from MD’s for medical orders, Medicare medical necessity, experience with commercial, Medicaid and managed care insurance, patient registration and preregistration, data entry, and generating Medicare reports and other duties as assigned by supervisor.
REFERENCES AVAILABLE UPON REQUEST
Contact this candidate