Detail-oriented professional with a proven track record in customer service and claims processing. Skilled in problem-solving and effective communication, ensuring accurate benefits verification and timely issue resolution.
Overview
14
14
years of professional experience
Work History
Customer Service Rep-Claims Associate
Alight
Florida City
12.2025 - Current
Provided excellent customer service to resolve customer complaints in a timely manner.
Resolved customer issues by providing accurate information and solutions.
Followed up with members to provide updates on the status of their claims, ensuring clear communication.
Submitted leave claims for Family and Medical Leave Act, Short-Term Disability, and Long-Term Disability to ensure compliance with policies.
Verified employee eligibility for various types of leave to determine their qualifications under company policies.
Documented customer interactions in the CRM system for record-keeping purposes.
Benefits Verification Specialist
CVS
09.2023 - 11.2025
Coordinated with insurance companies to obtain necessary information for benefit verification, facilitating prompt patient care.
Verified patient benefits using internal systems and databases, ensuring accurate information for treatment planning.
Checked patient eligibility and assessed coverage determination for prescribed services.
Reviewed insurance policies to determine coverage details for prescribed medications.
Followed up with patients on prior authorization requests, expediting processing and improving access to prescribed therapies.
Adhered to HIPAA regulations when handling confidential patient information.
Phone intake rep
CareCentrix
Troy
06.2021 - 08.2023
Provided excellent customer service by addressing patient inquiries promptly.
Assisted patients with insurance verification and eligibility checks.
Submitted prior authorization requests for necessary services.
Coordinated with healthcare providers to gather necessary documentation.
Processed prescription refills through mail order services.
Processed orders for medical supplies efficiently.
educate members on their benefits
Patient Registrar
Morrison Healthcare
Charlotte
11.2018 - 05.2021
Registered patient information using electronic health record systems.
Reviewed patient records to ensure accuracy of demographic information and insurance eligibility.
Handled phone inquiries and resolved scheduling conflicts promptly.
Greeted visitors and established purpose of visit to complete check-in procedure quickly.
Maintained confidentiality of patient records and sensitive information.
Front Desk Receptionist
Midtown OBGYN
Charlotte
07.2015 - 09.2018
Managed patient check-in and check-out processes smoothly and accurately.
Answered phone calls promptly, addressing inquiries and directing calls appropriately.
Answered incoming calls, redirected callers to the appropriate personnel or department, and took messages.
Maintained an organized reception area and ensured that all guests were attended to promptly.
Scheduled appointments using electronic health record system efficiently.
Handled billing inquiries and processed insurance information for patients effectively.
Maintained organized patient records in compliance with privacy regulations.
Performed data entry into computer systems to maintain accurate records of customer information.
Handled payment processing and provided customers with receipts and proper bills and change.
Customer Service Representative
TeleTech Holdings
Concord
03.2012 - 05.2015
Answered customer inquiries and provided accurate information regarding products and services.
Assisted customers with inquiries and resolved issues efficiently.
Managed customer accounts and processed service requests accurately.
Utilized CRM software to track interactions and enhance service delivery.
Provided detailed information on plan benefits to ensure member understanding.
Processed mail order prescription refills to guarantee timely delivery.
CSR (Customer Service Rep./Claims Specialist) at Social Security AdministrationCSR (Customer Service Rep./Claims Specialist) at Social Security Administration