Experience

Anthem

• United States
• Insurance
• 700 & Above Employee

• Claims and Benifits Customer Service Rep

  • Jul 2017 - Present

  I am the front line of all inbound calls for the Federal Employee Program, for providers and members. For members, This includes researching and communicating claims and benefits in an easy to understand way, escalating and resolving issues between the member and the provider in a timely manner, keeping the members plan and coordination of benefits up to date. For our providers, this includes giving correct benefits details per guidelines and procedure codes. Analyze and resolve all issues for the provider’s processed/processing claims.



Blue Shield of California

• United States
• Insurance
• 700 & Above Employee

• Information and Enrollment Processor

  • Feb 2015 - Jul 2017

  As a General Updates Processor I research inbound tasks to ensure accurate data entry, including maneuvering through multiple systems to retrieve and enter data. I also contract practitioners and facilities, making sure to organize and asses all information is valid for contracting. I preform inventory reduction consistently and apply guidelines and procedures to accurately maintain practitioner information.*contact and verify correct practitioner information,PDCs, and IPA's daily*understands and actively participates in all team meetings to ensure consistency*trained in intake, HMO, General updates, contracts, ERA/EFT, and Facility processing*escalates and resolves issues in a timely manner.