Precious Dillon
Denham Springs,LA
Summary
Dynamic Claims Representative with proven expertise at Medicaid, adept at enhancing customer satisfaction through effective claims processing and resolution. Skilled in insurance claims review and interpersonal communication, I successfully improved first-call resolution rates and built strong client relationships, ensuring compliance with industry regulations while maintaining high standards of service.
Experienced with evaluating claims for accuracy and compliance. Utilizes strong organizational skills and attention to detail to process claims efficiently. Track record of effectively communicating with clients and stakeholders to resolve claims disputes.
Overview
4
4
years of professional experience
Work History
Claims Representative
Medicaid
11.2023 - 02.2025
- Worked productively in fast-moving work environment to process large volumes of claims.
- Followed up with customers on unresolved issues.
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
- Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
- Processed claims for payment or forwarded to appropriate personnel for further investigation
- Prepared and reviewed insurance-claim forms and related documents for completeness.
- Provided technical assistance to staff members who had difficulty completing Medicaid forms accurately or efficiently.
- Developed strong relationships with clients, facilitating trust and open communication during the claims process.
- Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
Health Care Customer Service Representative
Conduent State Healthcare
10.2021 - 11.2023
- Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
- Enhanced patient satisfaction by efficiently addressing and resolving healthcare-related inquiries.
- Managed difficult conversations with compassion and professionalism, helping deescalate tense situations while maintaining a focus on finding resolutions.
- Increased first-call resolution rates by carefully listening to customers'' needs and providing accurate information based on their inquiries.
- Expanded knowledge on medical terminology and insurance policies through continuous learning initiatives, enhancing accuracy in communication with clients.
- Maintained accurate records of customer interactions, ensuring proper documentation within the company''s database.
- Streamlined appointment scheduling process by utilizing advanced software tools, optimizing time management for both patients and medical professionals.
Customer Service Representative
MMC Workforces Services
11.2020 - 10.2021
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
Education
Associate of Applied Science - Medical Assisting
Medical Training College
Baton Rouge, LA08-2026
High School Diploma -
Franklinton High School
Franklinton LA05-2013
Skills
- Microsoft office
- Insurance claims review
- Claims investigation
- Time management
- Data analysis
- Interpersonal communication
- Coverage determination
- Documentation review
Timeline
Claims Representative
Medicaid
11.2023 - 02.2025
Health Care Customer Service Representative
Conduent State Healthcare
10.2021 - 11.2023
Customer Service Representative
MMC Workforces Services
11.2020 - 10.2021
Associate of Applied Science - Medical Assisting
Medical Training College
High School Diploma -
Franklinton High School
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