A dedicated healthcare support professional with over 7 years of experience in customer service and back-office operations within the healthcare insurance industry. Proven expertise in handling healthcare provider inquiries, processing medical claims, and ensuring accurate and timely resolution of complex issues related to claims, appeals, and medical records.
From 2018 to 2024, I worked as a Customer Service Representative (CSR), where I managed inbound calls from healthcare providers, delivering accurate information regarding claim status, appeals, and patient medical records. I also handled escalated cases and supervisor calls, ensuring high-quality service and resolution. My role involved assessing provider concerns, identifying issues, and resolving them efficiently while maintaining professionalism and compliance.
Currently serving as a Back Office Agent (2024–present), I focus on medical claims processing, adjustments, and claims adjudication. I handle provider requests for medical records, review appeal determinations, and prepare formal correspondence related to clinical reviews. My work supports accurate documentation, compliance, and timely communication between healthcare providers and the organization.
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