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Healthcare Associate with 5+ years in healthcare and insurance operations
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Competencies
Managed medical claim reviews and billing adjustments to ensure accurate insurance reimbursements.
Verified insurance eligibility and determined coverage for healthcare plan members efficiently.
Supported financial operations through payment processing, reconciliation, and account follow-up.
Provided tech support, customer retention, and cross-selling in a fast-paced environment, ensuring high satisfaction.
Education
Languages
Summary
Experienced in healthcare operations, insurance claims processing, revenue cycle support, and customer service. Skilled in verifying insurance, processing claims, managing financial records, and engaging with customers to deliver quality support.
Key Achievements
- Processed and reviewed medical claims for insurance members, maintaining accuracy and compliance.
- Supported revenue cycle by reconciling payments and reducing discrepancies at Pharmbills.
- Handled customer interactions including cross-selling, tech support, and patient confidentiality protocols.
Experience
Healthcare Associate
Process and review medical claims for Humana Insurance members., Verify insurance eligibility and determine coverage based on type of member's plan, HMO and PPO., Apply appropriate billing adjustments to ensure accurate charge processing., Maintain compliance with healthcare protocols and...
Accounts Receivable Assistant
Processed and reconciled incoming payments to ensure accurate account balances., Support revenue cycle operations by reducing discrepancies and payment delays., Follow up on outstanding balances to ensure accurate financial records., Discussed prior authorizations issues with insurances.
Sales Associate
Performed cross-selling of internet, mobile and data services while meeting performance metrics., Provided first-level tech support assistance., Maintained high customer satisfaction standards in a fast-paced environment.