Khia Urans
Sacramento
Summary
Outgoing Customer Service Representative with experience overseeing multiple tasks and managing employees successfully. Hardworking professional committed to providing outstanding customer service and assistance. Pursuing full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise. Extremely versatile with extensive experience monitoring and maintaining service standards and call handling thresholds. Conscientious and personable supervisor with strong understanding of principles and procedures relating to customer service. Committed to contributing to superior service, maximum revenue generation and high productivity.
Overview
12
12
years of professional experience
Work History
Claims Analyst
Cigna
01.2023 - 02.2024
- Maintained strict confidentiality with all personal data as per company guidelines.
- Demonstrating a strong understanding of medical terminology is crucial for accurately processing medical claims. Your familiarity with medical terminology allows you to interpret and process claims effectively, ensuring accuracy in coding and billing procedures
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records. Attention to detail is essential in medical claims processing to ensure accuracy in coding, documentation, and billing
- information. Your meticulous approach to reviewing and verifying claim details helps prevent errors and discrepancies, leading to timely and accurate claim processing.
- Knowledge of healthcare regulations and compliance requirements is vital in medical claims processing. Your understanding of industry regulations, such as HIPAA and CMS guidelines, enables you to process claims in accordance with legal standards and maintain patient confidentiality and data security.
- Strong analytical skills are valuable for reviewing and assessing medical claims for accuracy and completeness. Ability to analyze claim data, identify discrepancies, and resolve issues efficiently contributes to the smooth processing of medical claims and timely reimbursement for healthcare providers.
Claims Processor
EDD
03.2022 - 03.2023
- Evaluated accuracy and quality of data entered into agency management system.
- Followed up with customers on unresolved issues.
- Collaborated with claims department and industry anti-fraud organizations to resolve claims.
- Established positive and trusting relationships with injured clients, administering efficient customer service and processing claims quickly.
- Maintained detailed and organized documentation of claim processing activities, ensuring that all relevant information was properly recorded and accessible. Proficiency in documenting claim details and outcomes contributes to transparency and accountability in the claims processing process.
- Used statistical analysis to determine if under/overpayment was granted, highlighting your ability to interpret and analyze data effectively. Skills in data analysis helped in identifying discrepancies and ensuring that claims were processed accurately and fairly.
Customer Service Team Lead
TeleDirect
02.2012 - 04.2021
- Resolved customer service issues using company processes and policies and provided updates to customers.
- Coached new team members on service techniques and provided scoring through quality assurance program.
- Promoted to team lead of customer service for displaying outstanding enthusiasm and remaining calm in extremely trying situations.
- Effectively supervised a team of 25+ customer service agents, ensuring they met and exceeded targets and goals. Leadership skills were crucial in managing and motivating your team to deliver exceptional customer service.
- Exhibited strong problem-solving skills by resolving customer issues and performing tasks requested by guests. Ability to think critically and find solutions to challenges demonstrates effectiveness in handling customer concerns and providing satisfactory resolutions.
- Managed customer calls efficiently in a fast-paced call center environment, demonstrating strong communication skills to address customer inquiries and resolve issues effectively. Ability to communicate clearly and professionally with customers and team members.
- Providing a diverse range of services for different clients supporting different business' as well as utilizing different platforms
Education
High School Diploma -
Pathway Academy
Sacramento, CASkills
- Team management
- Call center experience
- New process integration
- Staff monitoring
- Performance evaluations
- Data entry
- Customer service analysis
- Inbound and outbound calls
Timeline
Claims Analyst
Cigna
01.2023 - 02.2024
Claims Processor
EDD
03.2022 - 03.2023
Customer Service Team Lead
TeleDirect
02.2012 - 04.2021
High School Diploma -
Pathway Academy
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