KYIA BASNIGHT
Great Falls
Summary
Customer Service Rep with over 10 years of experience in telephone customer service, including tech support, and customer care. Familiar with major customer service software for loan payment, conflict resolution, and possess a positive attitude.
Overview
8
8
years of professional experience
Work History
Elite Customer Advocate
United Healthcare, UHG
Chico
11.2024 - 08.2025
- Answer up to 30 to 60 incoming calls per day from members of our health / dental /vision / pharmacy plans
- Performs claims adjustments / dollar payments to providers and / or members ultimately impacting UHC costs or commercial account costs
- Effectively refer and enroll members to appropriate internal specialists and programs, based on member’s needs and eligibility using multiple databases
- Interpret and translate clinical / medical terminology into simple - to - understand terms for members
- Respond to and resolve on the first call, member service inquires and issues by identifying the topic and type of assistance the caller needs, such as; benefits, eligibility and claims, financial spending accounts and correspondence
- Navigate through multiple platforms and databases to retrieve information regarding medical plans, prescription plans, flexible spending accounts, health reimbursement accounts, vision plans, dental plans, employer - based reward plans, claims submissions, clinical programs, etc.
- Must remain current on all communicated changes in process and policies / guidelines
- Adapt to all process changes quickly, and maintain knowledge of changes at site level and entity level by utilizing all available resources
- Resolve member service inquiries related to:
- Medical benefits, eligibility and claims
- Terminology and plan design
- Financial spending accounts
- Pharmacy benefits, eligibility and claims
- Correspondence requests
- Educate members about the fundamentals of health care benefits including:
- Managing health and well - being programs
- Maximizing the value of their health plan benefits
- Selecting the best health plan to meet their health needs
- Choosing a quality care provider and appointment scheduling
- Premium provider education and steerage
- Pre - authorization and pre - determination requests and status
- Benefit interpretation
- Self - service tools and resources
- Healthcare literacy (correspondence and literature interpretation)
- Work directly with site leadership to remove process barriers
- Navigate multiple online resource materials and follow defined process for issue handling
- Maximize use of community services, support programs, and resources available to member
Healthcare Advocate
United Healthcare, UHG
San Antonio
02.2023 - 10.2024
- Respond to and resolve, on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence
- Help guide and educate customers about the fundamentals and benefits of consumer-driven health care topics to select the best benefit plan options, maximize the value of their health plan benefits and choose a quality care provider
- Initiate proactive outreach to members as needed, which may involve welcoming new members to our health plans, addressing gaps in care, reviewing coverage, and referring & enrolling them to internal specialists and programs based on their needs and eligibility
- Contact care providers (doctor’s offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance
- Assist customers in navigating myuhc.com and other UnitedHealth Group websites and encourage and reassure them to become self-sufficient
Lending Service Agent
PNC BANK
San Antonio
10.2020 - 08.2022
- Performs customer service actitives and initiaties for a board range of products, services and problem resolution that occurs across multiple channels for our customers.
- Greeted customers and provided assistance with their inquiries.
- Followed up with customers to ensure satisfaction with services provided.
BUSINESS INSURANCE TRAINEE
Travelers Insurance
San Antonio
09.2021 - 07.2022
- Coordinated communication between clients and claims adjusters for efficient service.
- Utilized company software to track and manage claim statuses effectively.
- Collaborated with colleagues to streamline workflow and improve service delivery.
- Participated in training sessions to develop skills in customer service techniques.
Customer Service
PNC BANK
San Antonio
10.2019 - 10.2020
- Remote customer service with deposits and savings account.
- Assisted customers with account inquiries and transaction requests.
- Handled cash transactions accurately and efficiently.
- Educated clients on bank products and services available.
Technical Support Specialist
Kelly Services
San Antonio
07.2019 - 09.2019
- Repair, test, adjust, or install electronic equipment, such as industrial controls, transmitters, and antennas.
Claims Customer Service Representative (Claims CSR)
WPS Health Solutions
Hampton
11.2017 - 02.2019
- Obtain information from insured or designated persons for purpose of settling claim with insurance carrier.
Education
Diploma -
Sanford HS
Detroit06.2010
Skills
- Communication
- Ability to Multitask
- Fast Learner
- Adaptability
- Microsoft Office
- Ability to Work in a Team
- Communication Skills
- Ability to Work Under Pressure
- Computer Skills
- Customer Service
- Claims processing
- Benefit interpretation
- Customer outreach
- Healthcare literacy
- Customer relationship management
- Time management
- Process improvement
- Adaptability to change
- Team collaboration
- Active listening
Timeline
Elite Customer Advocate
United Healthcare, UHG
11.2024 - 08.2025
Healthcare Advocate
United Healthcare, UHG
02.2023 - 10.2024
BUSINESS INSURANCE TRAINEE
Travelers Insurance
09.2021 - 07.2022
Lending Service Agent
PNC BANK
10.2020 - 08.2022
Customer Service
PNC BANK
10.2019 - 10.2020
Technical Support Specialist
Kelly Services
07.2019 - 09.2019
Claims Customer Service Representative (Claims CSR)
WPS Health Solutions
11.2017 - 02.2019
Diploma -
Sanford HS