DJDjinah Josue
@djinahjosue
Customer service professional with expertise in claims and billing.
United StatesWhat I'm looking for
I am a dedicated customer service professional with over three years of experience in the healthcare and insurance sectors. My journey has equipped me with the skills to handle policy, billing, and claims inquiries effectively. I pride myself on my ability to resolve complex service issues with empathy and professionalism, ensuring customer satisfaction even in high-pressure environments.
Currently, I serve as a Claims Advocate at Vision Financial Services, where I manage inbound inquiries related to claims processing and policy updates. My previous roles, including Eligibility Specialist at Indiana Family and Social Services Administration and Claims Customer Service Representative at Sedgwick, have honed my ability to maintain detailed documentation while adhering to HIPAA guidelines. I am also certified in Epic, which enhances my understanding of regulated service practices and data security.
Experience
Work history, roles, and key accomplishments
Claims Advocate
Vision Financial Services
Oct 2023 - Present (1 year 9 months)
Resolved inbound inquiries related to claims processing, policy updates, and benefit explanations. Provided guidance on documentation and follow-up steps required by members, ensuring understanding and compliance.
Eligibility Specialist
Indiana Family and Social Services Administration (FSSA)
Feb 2022 - Present (3 years 5 months)
Handled high-volume inquiries related to Medicaid policies, renewals, and eligibility concerns with empathy and efficiency. Processed customer documentation, followed up on pending cases, and ensured case updates were reflected across systems.
Claims Customer Service Representative
Sedgwick
Jan 2021 - Present (4 years 6 months)
Managed calls and correspondence regarding billing issues and service requests. Explained policies and insurance procedures clearly to customers, contributing to reduced repeat calls.
Retail Team Leader
Barnes & Noble
Jun 2018 - Present (7 years 1 month)
Trained and supervised team members to ensure excellent customer service and adherence to retail policies. Managed POS transactions, returns, and inventory updates while maintaining customer satisfaction.
Education
Degrees, certifications, and relevant coursework
Southern New Hampshire University
Bachelor of Science, Health Information Management
Studied Health Information Management, focusing on the organization and management of health data. Gained expertise in healthcare regulations, data security, and information systems.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
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