Revonda M. Baldwin



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Revonda M. Baldwin

1600 Woodfield Creek Drive Phone: 828-409-0993

Wake Forest, NC 27687 revonda.baldwin@gmail.com
Career Target: Enrollment Specialist

Talented professional with 7+ years’ experience in health insurance and customer relations. Seeking to utilize my transferrable skills to become a contributing team member of a successful organization.


STRENGTHS & QUALIFICATIONS


  • Quality Assurance

  • Accuracy and Attention to Detail

  • Customer Support & Advocacy


PROFESSIONAL EXPERIENCE



HEALTH INSURANCE EXPERIENCE:
• Administered superior customer service to customers by providing assistance with claims payments

and/or reimbursements.


• Maintained HIPAA and PHI compliant practices by following standard policies and procedures.
• Responsible for reviewing medical records when necessary to determine if service rendered was based on

emergent diagnosis in order to apply policy directives.


• Processed ambulance claims with knowledge of ICD-9/10 and CPT procedure codes according to policy

stipulations for maximum benefits on behalf of customer.

• Prepared professional correspondence to request additional information for claim processing and

reimbursement.





CUSTOMER RELATIONS EXPERIENCE:

• Answered product and service questions; suggested information about additional products and services.

• Resolved product and service problems by clarifying the customers’ concerns, determined the cause of

the problem and then provided the best solution.

• Expedited enrollment corrections or adjustments to plans including processing of life events.

• Prepared product and service reports by collecting and analyzing customer information.


WORK HISTORY


    BEACON HEALTH OPTIONS, Morrisville, NC 2014 – Present

    Claims Processor/Adjuster

    UNITED HEALTH GROUP, Raleigh, NC 2013 2014



    Claims Adjuster

    VERITUDE @ FIDELITY INVESTMENTS, Durham, NC 2012 – 2013



    Health & Welfare Associate (Contract position)

    AFFILIATED COMPUTER SERVICES, Raleigh NC 2011 – 2012



    Tech Support/Apple Products Advisor

    ~Continued~



Revonda M. Baldwin Page 2

    CONVERGYS, Hickory, NC 2008 – 2009



    Customer Service Representative


EDUCATION

    CAMPBELL UNIVERSITY Expected December 2015



    AS, Business Administration



    COMPUTER SKILLS:

    Intermediate Microsoft Suite (Outlook, Excel, PowerPoint, and Word), Internet Research.



    Familiar with various systems and databases (Nasco, Comet, Unet, Lotus Notes, Service Connect).

    ~Excellent references provided upon request~


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