My experience in the healthcare industry has provided me with a strong foundation in insurance verification, claims management, patient coordination, and revenue cycle management. I began my healthcare career as a Customer Service Representative handling healthcare accounts, where I managed inbound and outbound calls, assisted members and providers with benefits, eligibility, claims inquiries, and healthcare-related concerns.
At Carelon Global Solutions (Anthem Blue Cross Blue Shield), I advanced into a Subject Matter Expert role, where I not only handled complex customer inquiries but also resolved claims-related cases to facilitate accurate and timely claim payments. I conducted detailed claim research, collaborated with onshore teams through email communications, and provided guidance to teammates to ensure operational efficiency and compliance with healthcare processes.Most recently, as a Medical Claim Analyst/Account Representative in Revenue Cycle Management (RCM) at Med-Metrix International, I gained hands-on experience with insurance verification, eligibility updates, claims follow-up, appeals, authorizations, and medical billing support. I worked extensively with primary, secondary, and tertiary insurance coverage, utilized multiple payer portals to verify benefits and claim status, and communicated directly with insurance companies when necessary. I also coordinated with clients regarding insurance updates, collected outstanding patient balances, requested medical records to support claim processing, and prioritized multiple projects while maintaining accuracy and productivity.
Throughout my healthcare career, I have developed strong analytical, communication, and problem-solving skills, allowing me to effectively manage claims, support patients and providers, navigate insurance requirements, and contribute to successful reimbursement outcomes. My combined experience in customer service, healthcare administration, and revenue cycle management has prepared me well for a role that requires insurance verification, prior authorizations, medical billing, claims follow-up, referral intake, and patient coordination.
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