Bernice Heyward
Beech Island
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
7
7
years of professional experience
Work History
Billing/Enrollment Specialist
Aetna Inc., CVS Health
11.2022 - Current
- Processes accurate and timely eligibility into Aetna Systems utilizing Aetna policy guidelines in accordance with key performance measures.
- Improves financial results by reducing losses associated with non-payment.
- Investigates, analyzes and resolves outstanding issues using a systematic approach in solving problems for enrollment and accounts receivable through analysis and evaluation of information and alternate solutions.
- Acts independently and manages its own activities with minimal supervision and direction to meet customer needs using sound decision making.
Customer Service Representative
Aetna Inc., CVS Health
05.2021 - 11.2022
- Operates multiple avenues of communication in a timely manner to provide accurate information regarding policy and coverage related questions.
- Performs review of member claim history to ensure accurate tracking of benefits maximum, coinsurance, and deductibles.
- Adheres to all HIPAA guidelines to protect all customer privacy.
- Assists healthcare providers with prior authorization status.
Human Services Specialist II
SC Department Of Health And Human Services
04.2019 - 04.2021
- Conducted thorough reviews and modifications of Medicaid eligibility determinations for aged, blind, disabled, and long-term care populations.
- Adhered to the agency’s policies and procedures for the analysis of applications.
- Ability to use all electronic tools and systems implemented to collect information regarding the applicant/beneficiary.
- Used multiple computer systems to handle situations that may have required extensive research
Education
Bachelor of Science - Human Resources Management
Grantham University
Lenexa, KS06.2026
Skills
- Billing Support
- Customer Engagement
- HIPAA Compliance
- Customer Service Background
- Client Advocacy
- Provider Relations
Timeline
Billing/Enrollment Specialist
Aetna Inc., CVS Health
11.2022 - Current
Customer Service Representative
Aetna Inc., CVS Health
05.2021 - 11.2022
Human Services Specialist II
SC Department Of Health And Human Services
04.2019 - 04.2021
Bachelor of Science - Human Resources Management
Grantham University