Cassandra Rich
@cassandrarich
Healthcare claims and provider services representative focused on accurate, HIPAA-compliant resolution.
What I'm looking for
I’m a detail-driven Customer First Representative with healthcare insurance experience supporting both medical and dental provider calls, claims, and benefits inquiries in fast-paced remote environments. I’m backed by 11 years of customer service excellence and a strong record of meeting performance targets while ensuring HIPAA compliance.
I handle claims denial research, appeal and documentation workflows, COB and eligibility verification, and payment/overpayment review—always working to deliver accurate, efficient claim and benefit outcomes. I also document actions carefully in internal systems and use tools like Excel and provider portals to ensure complete, compliant records and timely follow-up for providers and members.
Experience
Work history, roles, and key accomplishments
Handle high-volume provider calls for dental claims and benefit inquiries, including dental benefit interpretation, authorization requirements, and document submissions. Review remittances and claim/payment history, investigate denied claims and appeals, verify eligibility/COB, and maintain accurate compliant account notes.
Claims Research & Provider Adv
Jun 2024 - Apr 2026 (1 year 10 months)
Provide high-volume provider support for medical claims, payments, and documentation requirements. Research claim denials, submit reconsideration materials, track appeals, make appropriate claim adjustments/overrides, correct claim data in internal systems, and communicate outcomes via formal letters while logging daily productivity in Excel.
Childcare Provider
Putnam County Board of Education
Jul 2018 - Jun 2024 (5 years 11 months)
Support children in daily classroom activities by ensuring inclusion, monitoring safety and wellness, and maintaining accurate daily documentation. Handle parent inquiries and concerns, and respond to health-related needs using CPR and medical designee duties.
Childcare Provider Homemaker
Baxter
Nov 2012 - Jul 2018 (5 years 8 months)
Provide daily caregiving and maintain a safe, nurturing environment while managing household administrative and financial tasks. Perform meal preparation, coordinate appointments, and support child development through structured play and observation.
Customer Service
Staples
Jul 2006 - Nov 2012 (6 years 4 months)
Assist customers with product questions and resolve customer concerns in a retail environment while maintaining clean, organized work areas. Manage cash register balancing, perform copying/faxing tasks, conduct inventory cycle counts, and restock aisles based on planograms.
Cashier/Customer Service
Amoco
Jul 2004 - Jul 2006 (2 years)
Provide fast, accurate checkout and friendly customer service while handling cash register balancing. Support stocking and inventory counts, assist with food preparation and service, maintain a clean work environment, and direct daily work routines to ensure quality service.
Education
Degrees, certifications, and relevant coursework
University of Phoenix
Accounting
2009 -
Completed accounting education at University of Phoenix beginning in May 2009.
Availability
Location
Authorized to work in
Job categories
Skills
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