Sherese Vanderveer

Experience

• 

  Cigna

  Nov 2001 - Nov 2015

  Senior Appeals Processor

  Review and process appeal requests from healthcare providers regarding incorrect payments or benefitsProcess and/or adjust claims or send appeal decision letters based on outcomeCall provider for additional information required in order to process appealsAssist co-workers by handling any work that may become due while they are on vacation.Knowledge of HIPAA guidelines for handling of personal and private informationHandled inbound & outbound callsKnowledge of claims and appeals processing procedures and guidelines to route to the correct team for handlingProvided excellent verbal and/or written communication to all parties of interest Show less

• 

  Rotech Healthcare

  Apr 2016 - Apr 2017

  Patient Account Specialist II

  Manage insurance changes in the system by conducting insurance verifications & eligibility for services & products Build relationships with Rotech DME locations, providers and referral sources throughout the USProactively obtain re-certifications & re-authorizations while providing timely resolution for accounts in non-payable status; held item, no charge, hold & audit reviewsThorough review & QA of physician’s orders, testing, progress notes & medical necessity for payer requirementsProcess Cpap supply orders for patients over the phoneHandled inbound & outbound calls Show less

• 

  Convergys

  Jul 2017 - Apr 2019

  Customer Service Representative

  HRBlock Agent 01/2019-04/2019Do It Yourself Online Support. Help troubleshoot and help client navigate through Online productsAppointment Setting. Assist client to set a date to see a tax professional to get their taxes prepared.OnStar Customer Service & Problem Resolution Rep II 07/2017 - 11/2018Ensure service delivered to our customers meets contractual Key Performance Indicator (‘KPIs’) Clarify customer requirements; probe for understanding, use decision-support tools and resources to resolve customer issues that are non-standard/unstructured and require some clarification or conceptual thinking Listen attentively to customer needs and concerns; demonstrate empathy while maximizing opportunity to build rapport with the customer Greet customers in a courteous, friendly, and professional manner using agreed upon procedures Maintain broad knowledge of client products and/or services Prepare complete and accurate work including appropriately notating accounts as required Participate in activities designed to improve customer satisfaction and business performance Offer additional products and/or services Track, document and retrieve information in call tracking database Show less

• 

  NTT DATA Services

  Sept 2019 - Nov 2020

  Claims Processor