Ellana Johnson
Summary
Detail-oriented and customer-focused professional with 3 of experience in claims processing, customer service, and administrative support. Proven ability to analyze claims, resolve discrepancies, and maintain compliance with organizational policies and regulations. Adept at managing multiple priorities while delivering exceptional service in high-pressure environments. Seeking to contribute to UnitedHealthcare's mission as an Associate Claim Representative by leveraging strong problem-solving, communication, and analytical skills.
Overview
4
4
years of professional experience
Work History
Claims Associates
Sedgwick Claims Management
02.2021 - 12.2024
- Reviewed and processed the standard amount claims per day with a 100% accuracy rate, ensuring adherence to company and regulatory guidelines.
- Investigated and resolved discrepancies in claims data, collaborating with internal teams and external stakeholders to expedite resolutions.
- Delivered exceptional customer service by addressing inquiries and concerns related to claims status, billing, and policies.
- Maintained meticulous documentation of claim activities in compliance with HIPAA and organizational standards.
- Implemented process improvements that reduced average claim processing time by 100%.
Insurance Verification Specialist
Teleperformance USA
02.2022 - 02.2023
- Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Updated patient records with accurate, current insurance policy information.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
Education
High School Diploma -
Northview High School
Dothan05-2014
Skills
- Claims processing software
- Proficient in Microsoft Office Suite (Word, Excel, Outlook)
- Knowledge of healthcare regulations and coding (eg, ICD-10, CPT)
- CRM and ticketing systems: [eg, Salesforce, Zendesk]
- Claims investigation
- Policy interpretation
Timeline
Insurance Verification Specialist
Teleperformance USA
02.2022 - 02.2023
Claims Associates
Sedgwick Claims Management
02.2021 - 12.2024
High School Diploma -
Northview High School
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