CIERRA ALEXANDER
Raleigh
Summary
I am a highly motivated results-driven leader who successfully delivers impeccable customer service and case management support. I deliver excellent oral and written communication with superb attention to detail, while seamlessly interfacing among internal teams and clients. I pride myself in promoting unmatched professionalism, sound ethics, and corporate confidentiality practices to meet the company's goals and objectives.
Overview
9
9
years of professional experience
Work History
Reimbursement Case Manager
Blue Cross Blue Shield
12.2021 - 07.2025
- Enhanced reimbursement procedures by streamlining the claims submission process and reducing processing time. Improved departmental accuracy through meticulous attention to detail while reviewing claims submissions.
- Managed high-volume workloads through effective prioritization and organization, consistently meeting deadlines while maintaining accurate records.
- Collaborated closely with medical coders to ensure accurate representation of services provided, resulting in optimized reimbursement potential.
- Determine prior authorizations for medications. Submit appeals and denied medication coverage. Contributed to increased team productivity by consistently meeting or exceeding individual processing goals.
Healthcare Advocacy Representative
Diversity Systems
04.2022 - 05.2025
- Enhanced healthcare service quality by collaborating with medical professionals and providing accurate patient information. Promoted patient well-being through empathetic communication, advocacy, and personalized care planning.
- Applied administrative knowledge and courtesy to explain procedures and services to patients. Answered incoming calls, scheduled appointments, and filed medical records. Responded to inquiries by directing calls to appropriate personnel.
- Fostered a culture of patient-centered care by consistently prioritizing the unique values, beliefs, and preferences of each individual. Compiled and maintained patient medical records to keep information complete and up-to-date.
- Delivered comprehensive case management services that ensured continuity of care across multiple providers while minimizing gaps in service provision.
Insurance Reimbursement Specialist
RareMed Solutions-Remote
12.2016 - 08.2018
- Responded to inquiries from healthcare providers regarding prior authorization requests. Achieved timely reimbursements for clients through diligent follow-ups with insurance carriers. Improved claim processing efficiency by streamlining workflows and implementing best practices.
- Enhanced communication between healthcare providers and insurance companies, ensuring prompt resolution of issues related to prior authorizations.
- Managed a high volume of incoming calls, maintaining professionalism while effectively addressing the needs of callers seeking assistance with prior authorizations.
- Achieved high success rate in obtaining authorizations by effectively demonstrating medical necessity through comprehensive documentation and clear communication with insurance companies.
Education
High school diploma -
Millbrook High School
06.2012
Skills
- Records Management
- Task Prioritization
- Epic
- ICD-10
- Time Management
- Medical Pre Authorization
<Enter your own>
Timeline
Healthcare Advocacy Representative
Diversity Systems
04.2022 - 05.2025
Reimbursement Case Manager
Blue Cross Blue Shield
12.2021 - 07.2025
Insurance Reimbursement Specialist
RareMed Solutions-Remote
12.2016 - 08.2018
High school diploma -
Millbrook High School
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