Khadijah Legette
Columbia
Summary
Detail-oriented Claims Processing and Customer Service professional with 5 years of experience in healthcare and insurance operations. Expertise in claims review, documentation verification, HIPAA compliance, and complex customer inquiry resolution. Strong analytical skills and proven ability to meet productivity and quality standards while maintaining confidentiality. Effective communicator and organizer, skilled in managing multiple software applications in a remote work environment.
Overview
5
5
years of professional experience
Work History
Healthcare Customer Service Representative (Part-T
UnitedHealth Group (Remote)
02.2025 - Current
- Provide customer support to members regarding healthcare benefits, claims status, and coverage details.
- Handle inbound calls and respond to inquiries with professionalism and empathy.
- Assist customers with resolving billing issues and navigating healthcare services.
- Document customer interactions accurately in internal systems.
- Maintain compliance with HIPAA and company confidentiality standards.
- Collaborate with internal teams to resolve complex customer concerns.
- Manage multiple systems and tasks efficiently in a remote work environment.
Claims Processing Specialist
Gainwell Technologies
Columbia
03.2024 - Current
- Process medical and insurance claims accurately while meeting daily production and quality standards.
- ● Review claim documentation for completeness and verify eligibility and required information.
- ● Research and resolve claim discrepancies following company policies and procedures.
- ● Enter and update claim information in multiple computer systems with a high level of accuracy.
- ● Maintain confidentiality of protected customer information.
- ● Communicate with providers and internal departments to obtain missing documentation.
- Utilize Microsoft Word, Excel, Outlook, and multiple claims processing applications simultaneously.
Claims Processing Associate
Cognizant (Remote)
Columbia
06.2021 - 03.2024
- Reviewed and processed healthcare claims, ensuring compliance with established guidelines and contributing to accurate claims handling.
- Verified customer and provider information, enhancing accuracy in claim adjudication and minimizing discrepancies.
- Identified errors, corrected claim information, and escalated complex issues when necessary.
- Performed high-volume data entry while maintaining exceptional attention to detail.
- Managed multiple tasks and priorities in a fast-paced remote work environment.
- Met productivity, accuracy, and quality assurance goals consistently.
- Provided customer support on claim status and documentation requirements, facilitating timely resolution and improving customer satisfaction.
Education
Mullins High School
Mullins, SCSkills
- Claims processing
- Keyboarding and Microsoft Office
- Attention to detail
- Problem-solving
- Multitasking
- High school diploma/GED qualification
Timeline
Healthcare Customer Service Representative (Part-T
UnitedHealth Group (Remote)
02.2025 - Current
Claims Processing Specialist
Gainwell Technologies
03.2024 - Current
Claims Processing Associate
Cognizant (Remote)
06.2021 - 03.2024
Mullins High School